Zickel supracondylar nails for fractures of the distal end of the femur.

Between 1974 and 1984 the Zickel supracondylar nail system was used to fix 82 femora. Sixty-nine femora had supracondylar fractures and 13 supracondylar osteotomies. A high rate of union (98%) was achieved in the fracture group, which included a variety of fracture types, but five supracondylar osteotomies failed to unite initially and required additional surgery. Knee motion exceeded 90 degrees in 70% of the femora that healed but was poorest in the T or Y intracondylar fracture group, in which only 46% exceeded 90 degrees. The operation may be performed as either open or closed nailing. Closed nailing, when possible, is the procedure of choice because of the decreased postoperative morbidity and increased knee motion. Two-thirds of this series were patients older than 60 years, and the device seems particularly helpful in aged individuals.