Abstract: Introduction:Fractures of the distal femur are complex injuries that pose a challenge to the orthopaedic surgeon. It constitutes about 7 % of all femoral fractures. It usually occurs during high energy trauma in younger patients and frequently are associated with concomitant injuries. In contrast, elderly patients with severe osteopenia might sustain solitary distal femoral fractures from minor trauma such as a simple fall. Despite advances in implants, much confusion exist regarding choice of implant.
Method and Material: we conducted a prospective randomized study from 2017 to 2019 in which, analysis of 30 patients was done out of which 15 cases were treated in each group with follow-up at 6,12,24 weeks. Muller classification was used to grade the fractures, taking type A1-3 in inclusion criteria and type B, C under exclusion criteria.
Results: KOOS scoring was used to evaluate final outcomes which demonstrated that in RN group, 2 cases were excellent, 7 cases were good, 6 cases were fair, while in LP group: 1 case was excellent, 6 cases were Good and 8 cases were fair and 1 case was poor. Over 80% of fractures under RN and LP healed within 6 months with average time being 21.0 weeks (range 12 to 28 weeks) in RN and 23.03 weeks (range 12-32 weeks) in LP group.
Conclusion: Both retrograde IM nailing and LCP plating may be adequate treatment options for distal femur fractures. Early healing, increase range of movement, less average surgical time, more complications are seen in nailing compared to plating but are statistically insignificant, the reason for these results is mostly due to simple fractures treated by nailing and complex ones by plating. No significant differences in outcome between implants regarding fracture healing, non-union were found for both the techniques. However, both procedures need correct preoperative planning and adequate surgical experience so as to avoid revision surgery.
