Vol. 11, Issue 4 (2025)

Background: Early mobilization and stable fixation are challenging to achieve in complex injuries such as distal femur and supracondylar fractures. Retrograde intramedullary nailing is a minimally invasive technique that preserves the soft-tissue envelope, reduces blood loss, and facilitates early rehabilitation. This study evaluates the efficacy and functional outcomes of retrograde intramedullary nailing in the management of distal femur and supracondylar fractures.

Materials and Methods: A prospective study was conducted on 20 patients with distal femur and supracondylar fractures who underwent retrograde intramedullary nailing. Patients were followed for 4 to 14 months. Early postoperative knee mobilization and quadriceps strengthening were encouraged, with weight bearing progressed according to radiological evidence of fracture union. Functional outcomes were assessed using the Hospital for Special Surgery (HSS) Knee Rating System, and complications were recorded.

Results: Nineteen patients completed final follow-up. The mean patient age was 38 years, with males comprising 80% of the cohort. Good to excellent outcomes were observed in 63.16% of patients, fair outcomes in 21.05%, and poor outcomes in 15.79%. Knee stiffness 40% was the most common complication, followed by knee pain 20%, delayed union 15%, infection 5%, nail impingement 5%, and limb-length discrepancy 10%.

Conclusion: Retrograde intramedullary nailing provides stable fixation with minimal soft-tissue disruption and facilitates early mobilization, resulting in reliable fracture union and satisfactory functional recovery. It is a dependable and efficient treatment, especially for osteoporotic and comminuted fractures, due to its high union rates and acceptable functional recovery.