Comparative Study Of Functional Outcome Of Retrograde Nailing Versus Locking Compression Plate In Distal End Femur Fracture

Abstract

Background and Objectives: Distal femoral fractures reportedly account for less than 1% of all fractures and comprise between 4%–6% of all femoral fractures. The presentation in younger patients is primarily due to high energy injuries and can present in the elderly age group due to trivial trauma due to pre-existing osteoporosis. There are various methods for treating distal femur fractures and the present study compares the treatment of extraarticular distal femoral fractures using retrograde nailing versus use of locking compression plate.

Materials and Methods:  It is a prospective study conducted from February 2023 to February 2025 in Adichunchanagiri Institute of Medical Sciences, B.G. Nagara, Mandya. 30 cases of extraarticular distal femoral fractures using retrograde nailing and locking compression plate. Outcomes were assessed based on operative parameters, functional score (Neer score), time to union and complications.

Results: Around 60% cases were female, with most cases falling in the 51-60 age group, The mean age of IMN group was 49.67±9.53 years and LCP group was 58.6 ± 12.98 years. Right femur was affected more (63%) than left, with majority injuries (57%) occurring as a result of accidental self-fall. Functional outcome was assessed using Neer’s Scoring System which showed IMN group, total 6(40%) cases are excellent,6(40%) cases are good, 2(13 %) case are fair and 1(7%) case was poor result. In LCP group total 5(33%) cases are excellent,6(40%) cases are good, 1(7%) was fair and 2(13%) was poor. Complications like infection (1 case), anterior knee pain (2 cases), knee stiffness (1 case), limb shortening (1 case), non-union (1 case) were seen in patients managed by retrograde nailing, whereas knee pain (1 case), knee stiffness (2 cases), infection (3 cases) and non-union (2 cases) for plating cases. Mean Neer score in the group IMN was 82.2±17.77 and in the group LCP was 80.27±20.93.

Conclusion: Both retrograde intramedullary nailing and the use of locking compression plates may be considered as adequate treatment options. Early healing, increase range of movement, less average surgical time, less complications are seen in nailing compared to plating but are statistically insignificant with similar functional outcomes. Thus, it can be concluded that both techniques may be used for the treatment of distal femoral fractures if correct operative methods and postoperative protocols are followed.