Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient

Introduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be p...

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Main Authors: Jacob A Linker, Abhishek Ganta, Kenneth A Egol, Sanjit R Konda
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-01-01
Series:Journal of Orthopaedic Case Reports
Subjects:
Online Access:https://jocr.co.in/wp/2025/01/01/outcome-of-a-nail-plate-fixation-combination-for-a-distal-femur-fracture-in-a-99-year-old-patient/
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author Jacob A Linker
Abhishek Ganta
Kenneth A Egol
Sanjit R Konda
author_facet Jacob A Linker
Abhishek Ganta
Kenneth A Egol
Sanjit R Konda
author_sort Jacob A Linker
collection DOAJ
description Introduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be performed percutaneously and expeditiously even in extremely old patients; therefore, patient age should not be a limiting factor in choosing this construct to allow for immediate weight-bearing. Case Report: The patient was a 99-year-old female who presented to the emergency room after a fall. Plain radiographs demonstrated a comminuted supracondylar distal femur fracture with a sagittal intercondylar split (OTA classification 33A3.3). She was indicated for operative repair and was fixed with a combination of a retrograde Stryker T2 alpha nail and Stryker distal femur locking plate. This method was chosen to allow the patient to be weight-bearing as tolerated after surgery so she could immediately start work with physical therapy to work towards getting back to her pre-injury ambulatory status. At 3 months post-operatively, she had minimal pain, no difficulties with activities of daily living, and was ambulating with the assistance of a cane. At 9 months post-operatively, she was ambulating with a cane (pre-injury status). She did not report any pain, and her radiographs illustrated fracture site consolidation. Furthermore, her short musculoskeletal functional assessment score was the same as it was pre-injury (81). Conclusion: This case supports the idea of using a nail-plate combination for repair of intra-articular distal femur fractures, even in the very elderly as the patient’s functional outcome data reached pre-injury levels. In addition, it allows even elderly patients to begin early weight-bearing and decreases complications related to lack of extremity use.
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spelling doaj-art-3040eea7d3594f5e9033d26363af82c62025-08-20T02:10:17ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-01-01151465010.13107/jocr.2025.v15.i01.5120Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old PatientJacob A LinkerAbhishek GantaKenneth A EgolSanjit R KondaIntroduction: This report describes the use of a combination of a retrograde femoral nail and distal femur locking plate for the treatment of an open intra-articular distal femur fracture in a 99-year-old female. The purpose of this report is to highlight that nail-plate fixation constructs can be performed percutaneously and expeditiously even in extremely old patients; therefore, patient age should not be a limiting factor in choosing this construct to allow for immediate weight-bearing. Case Report: The patient was a 99-year-old female who presented to the emergency room after a fall. Plain radiographs demonstrated a comminuted supracondylar distal femur fracture with a sagittal intercondylar split (OTA classification 33A3.3). She was indicated for operative repair and was fixed with a combination of a retrograde Stryker T2 alpha nail and Stryker distal femur locking plate. This method was chosen to allow the patient to be weight-bearing as tolerated after surgery so she could immediately start work with physical therapy to work towards getting back to her pre-injury ambulatory status. At 3 months post-operatively, she had minimal pain, no difficulties with activities of daily living, and was ambulating with the assistance of a cane. At 9 months post-operatively, she was ambulating with a cane (pre-injury status). She did not report any pain, and her radiographs illustrated fracture site consolidation. Furthermore, her short musculoskeletal functional assessment score was the same as it was pre-injury (81). Conclusion: This case supports the idea of using a nail-plate combination for repair of intra-articular distal femur fractures, even in the very elderly as the patient’s functional outcome data reached pre-injury levels. In addition, it allows even elderly patients to begin early weight-bearing and decreases complications related to lack of extremity use.https://jocr.co.in/wp/2025/01/01/outcome-of-a-nail-plate-fixation-combination-for-a-distal-femur-fracture-in-a-99-year-old-patient/distal femurfemoral naildistal locking plategeriatricopen fracture
spellingShingle Jacob A Linker
Abhishek Ganta
Kenneth A Egol
Sanjit R Konda
Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
Journal of Orthopaedic Case Reports
distal femur
femoral nail
distal locking plate
geriatric
open fracture
title Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
title_full Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
title_fullStr Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
title_full_unstemmed Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
title_short Outcome of a Nail-plate Fixation Combination for a Distal Femur Fracture in a 99-year-old Patient
title_sort outcome of a nail plate fixation combination for a distal femur fracture in a 99 year old patient
topic distal femur
femoral nail
distal locking plate
geriatric
open fracture
url https://jocr.co.in/wp/2025/01/01/outcome-of-a-nail-plate-fixation-combination-for-a-distal-femur-fracture-in-a-99-year-old-patient/
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AT kennethaegol outcomeofanailplatefixationcombinationforadistalfemurfractureina99yearoldpatient
AT sanjitrkonda outcomeofanailplatefixationcombinationforadistalfemurfractureina99yearoldpatient