A Comparative Study Of Results Of Treatment Of Distal Femur Fracture By Retrograde Nail Vs Locking Compression Plate Outcome Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 0
Abstract
Background: Distal femur fractures represent between 4 to 6% of all femoral fractures. Both retrograde intramedullary nails and locking compression plates are used with good success. Aim: The aim of this study is to compare clinical and radiological outcomes of retrograde intramedullary (IM) nailing and locking compression plate for treating distal femoral fractures. Materials and Methods: In a prospective study from February 2014 to October 2015, we analysed 60 patients of distal femur fracture treated by retrograde intramedullary nailing (30) (RN group) and locking compression plate (30) (LCP group). Mean age in the two groups was 52.03 yrs (21-80yrs). Majority of the patients were males (75%) in both the groups. Mechanism of injury was high energy impact in 37 patients (61.67%) and low energy impact in 23 patients (38.33%). According to AO classification there were 24 type A fractures (RN=16, LCP=8) and 36 type C fractures (RN=14,LCP=22). 13 cases of RN group (43.33%) and 14 cases of LCP group (46.67%) were compound fractures. Results: In RN group, 2 out of 30 patients(6.67%) while in LCP group 1 out of 30 patients(3.33%) developed non-union. Additional secondary bone grafting was required 3 months after the primary operation in 2 patient(6.67%) in RN group and 1 patient(3.33%) in the LCP group. 1 patient in the RN group and 2 in LCP group had superficial infection while 1 patient in LCP group had deep infection. Mean range of movement was 118.93°±17.30° in LCP group and 109.03°±18.78° in RN group. Overall results according to Schatzker and Lambert criteria were better with LCP as compared to retrograde nail. Conclusion: Main disadvantage of retrograde nailing is persistent knee pain and its inability to be used in complex type C fractures. Locking compression plates can be used for all distal femur fractures including complex type C fractures. Thus LCP appears to be a better choice over retrograde nail for treating fractures of distal femur.
Authors and Affiliations
Paras Gupta, Saurabh Agrawal, Shubham Kejariwal
Keywords
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