Abstract
Introduction
This study aimed to compare MIPO and IMNr in the treatment of supracondylar femur fracture following TKA in respect of fracture healing, complications and functional results.
Materials and Methods
A retrospective analysis was made of 32 supracondylar femur fractures classified according to the Rorabeck classification, comprising 20 cases treated with MIPO and 12 with IMNr. The two techniques were compared in respect of ROM, KSS, SF-12 scores, intraoperative blood loss, surgery time, and radiological examination findings.
Results
No significant difference was determined between the two groups in respect of age, gender and fracture type, or in the median time to union (MIPO 4.3 months, IMNr 4.2 mths) (p >0.05). In the MIPO group, 2 patients had delayed union, so revision surgery was applied. The mean postoperative ROM was comparable between IMNr and MIPO (86.2 °vs 86 °, p > 0.05). The mean Knee Society Score (KSS) and SF-12 score did not differ between the IMN and MIPO groups. (p>0.05). Reduction quality in the sagittal plane was better in the MIPO group and no difference was determined in coronal alignment. Greater shortening of the lower extremity was seen in the IMNr group than in the MIPO group. (20.3 vs 9.3mm, p<0.05). Perioperative blood loss was greater (2 units vs.1.2 units) and mean operating time was longerin the MIPO group. (126.5 min vs 102.2 min, p<0.05)
Conclusion
In patients with good bone stock, supracondylar femur fracture following TKA can be treated successfully with IMN or MIPO. IMN has the advantage of less blood loss and a shorter operating time. Reduction quality may be improved with the MIPO technique. Both surgery techniques can be successfully used by orthopaedic surgeons taking a case-by-case approach
