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Treatment of extra-articular distal femur fractures by Retrograde Nail Versus distal femoral locked plate: A comparative study

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Dr. Nilesh R. Charel, Dr. M. M. Prabhakar, Dr. Nilesh R. Charel
» doi: 10.31838/ecb/2023.12.si6.009


Extra articular distal femoral fractures are among challenging orthopaedic injuries. Anatomical locked plating and retrograde nailing are two commonly use methods for fracture fixation in such patients. Purpose of this study was to compare Anatomical distal femur locked plating and retrograde intramedullary nailing for treatment of extra articular type A distal femur fractures. Materials and Methods: A prospective randomized study including 20 patients of extra articular distal femur fractures were operated in the department of orthopeadic surgery, DR.M.K.SHAH M.C.R.I. Patients were divided in two groups by random allocation. Patients of group A (10 patients) were treated by distal femoral locked plating and group B (10 patients) by retrograde distal femoral nailing using standard technique.The patients were follow up monthly for six months thereafter in 12 & 18 months. On every follow-up, radiological sign of healing, range of movement of knee, initial complications like infection & knee pain were noted and functional outcome scoring was done as per Neer’s score. Results: The mean duration of surgery in retrograde nailing group was 68 ± 12.2 minutes while it was 81 ± 11.6 minutes in platting group which was statistically significant. Average fracture union time was better in retrograde nailing (15.2 ± 1.2 weeks) than platting group (18 ± 1.4 weeks) as assessed both clinically and radiologically (p-value=0.0001). The average knee flexion was good in nailing (104.8 ± 9.4) than plating(91.4 ± 8.9)(p-value=0.0042). Postoperative Neer’s score was higher in retrograde nailing (86.2 ± 10.6) than the plating group (63.8 ± 9.4) which was statistically significant. Conclusion: In our study functional results trended toward better outcomes in retrograde femoral nails than plates in terms of knee flexion, early weight bearing, time to union, blood loss, operative time.

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