Abstract: Background: Distal femoral fractures reportedly account for less than 1% of all fractures and comprise between 4%–6% of all femoral fractures. The current method of open reduction and internal fixation has become evident in the recent years with good results being obtained with the AO blade plate, dynamic condylar screw and other implant systems like intramedullary retrograde nails and recently locking compression plate. Controversy still remains regarding the optimum device for distal femur fixation.
Objectives: To compare functional outcomes of fractures of distal femur operated with distal femur locking compression plate and distal femur nail using range of motion at knee and Neers knee scoring system and to compare rate of complications associated with both treatment modalities.
Materials and methods: In this retrospective study, 60 patients with displaced distal femur fractures presented to our hospital were studied from January 2012-june 2017. 30 patients underwent fixation with locking compression plate and rest 30 underwent distal femur nailing. Outcomes were measured and assessed at 1 months, 3 months and 6 months using Neers knee scoring system.
Results: Union was achieved in all patients with mean time to radiological union being 20 weeks in retrograde nailing patients and 24 weeks in locking compression plating. Neer scores were graded as excellent in 51.7 % in retrograde nailing patients and 56.6 % in plating patients. Mean range of motion was more (115 degree) in retrograde nailing patients compared to locking compression plating patients (114 degree) at the end of follow up.
Conclusion: There were no statistically significant differences found in functional outcome of the patients between the two surgical methods. Locking compression plate is better implant in comminuted intra-articular fractures of distal end of femur, particularly in elderly patients with osteoporotic bone. Retrograde intramedullary nailing is a good operative technique for extra-articular distal third femoral fractures. However, both techniques require sufficient surgical experience and appropriate preoperative planning.
