A COMPARATIVE STUDY IN MANAGEMENT OF DISTAL FEMUR FRACTURES BY DISTAL FEMUR LOCKED COMPRESSION PLATE VERSUS RETROGRADE NAILING

Abstract

Background : Distal femoral fractures comprise approximately 3%–6% of all femoral fractures. The associated mechanism of injury can be of high or low energy. Surgery is the standard mode of treatment aiding for early weight bearing and mobilization is required in order to prevent longterm complications due to prolonged bed rest. Open reduction and internal xation using extra-medullary implants have been the standard treatment for supracondylar fractures, irrespective of age group with high complication rates including delayed union; implant failure, and infection. Transmedullary nail offers a potential biomechanical advantage over side plates and screws because of intramedullary location; resulting in less stress over the implant and better stress distribution than with eccentric side plate and screws.6 While both techniques are considered standard , the merits and demerits of each technique may be different; leading to better results or alignment using one over the other. This study aims at comparing the two xation methods. A total of 70 patients who met the inc Materials and methods: lusion criteria were included in the study and were divided into 2 groups- Group A comprised those patients treated with Retrograde Nailing (n=35) while Group B patients were treated with Distal Femur Locking Compression Plate(n=35). All post-operative patients were evaluated at 2weeks, 4weeks, 3 months and 6months. Results and conclusion: It was found out that the mean Range of Motion (ROM) evaluated at 6 months was 119.85 (-+21.11) degrees for the RN group while it was 110.0(-+18.85) degrees in the DFLCP group and was statistically signicant with p=0.044 , also the functional outcome assessed by AKSS was statistically signicant (p=0.03) favoring the RN group over the DFLCP group. Similar signicant outcomes were obtained in terms of duration of surgery and amount of blood loss favoring RN group . The radiological union time for RN group was 12 weeks compared to 13.21 weeks in case of DFLCP group , but was not statistically signicant (p=0.100). Hence , distal femur fractures especially the extra articular type had good outcome when treated with RN compared to DFLCP , when intervened early and coupled with adequate post operative physiotherapy.