The supracondylar intramedullary nail in elderly patients with distal femoral fractures.

From February 1994 until July 1997, a prospective study of all elderly patients with a displaced distal femoral fracture, who were treated with an intramedullary supracondylar nail, was made. The outcome of 31 fractures in 30 elderly patients was studied. The average age was 82 years (55-98). Two-thirds of the patients had had previous ipsilateral femoral pathology. Average acute hospital stay was 17 days. All patients were reviewed at 6 months and all cases have been followed for over 1 year. More than 90% of surviving fractures had healed within 6 months of the operation. Outcome scores were; 22 (85%) excellent or satisfactory, 2 (7.5%) unsatisfactory and 2 (7.5%) failures. The mortality rate was 17% at 6 months and 30% at 1 year, which is similar to patients with a fractured neck of femur. This nail is recommended for its versatility and favourable outcome scores in this age group.