A comparative prospective study of retrograde nailing versus locked compression plating in distal third femur fractures

Sabavath Deepthi; Mise Priyanka; Fatima Heba Habeeb; Bharath Kumar S.

doi:10.18203/issn.2455-4510.IntJResOrthop20243900

Authors

Sabavath Deepthi Department of Orthopaedics, Mamata Medical college, Rotary Nagar, Khammam, Telangana, India
Mise Priyanka Department of Orthopaedics, Mamata Medical college, Rotary Nagar, Khammam, Telangana, India
Fatima Heba Habeeb Department of Orthopaedics, Gandhi Medical college, Secunderabad, Telangana, India
Bharath Kumar S. Department of Orthopaedics, Mamata Medical college, Rotary Nagar, Khammam, Telangana, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243900

Keywords:

Distal third femur fractures, Retrograde femur nailing, Locked compression plating

Abstract

Background: Treatment of distal femur fractures is complicated by the fact that the majority of these fractures occur near to transverse neurovascular structures. Present study aimed to assess the outcome in patients undergoing retrograde nailing vs locked compression plating in distal third femur fractures.

Methods: The present prospective study was conducted among all the patients visiting Mamata general hospital Khammam with distal third femur fractures between age 18-80 years during the period of October 2020- September 2022. The patients were treated with retrograde nailing in group and locked compression plating in another group of patients with distal third femur fracture.

Results: On assessment of the clinical outcome during the follow-up period, there is significantly lower clinical outcome score among the patients in the nailing group compared to the plate. Similarly, the radiological scores between the groups, there is significantly higher mean score among the patients in the nail group compared to the plate group.

Conclusions: The present study showed a significant clinical outcome and radiological score among the patients treated with retrograde nailing compared to the patients treated with locking compression plating technique for distal third fracture of femur.

Metrics

Metrics Loading ...

References

Kolmert L, Wulff K. Epidemiology and treatment of distal femoral fractures in adults. Acta Orthop Scand. 1982;53(6):957-62.

Martinet O, Cordey J, Harder Y, Maier A, Bühler M, Barraud GE. The Epidemiology Of fractures of the distal femur. Injury. 2000;31:62-94.

Arneson TJ, Melton 3rd LJ, Lewallen DG, O’Fallon WM. Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. Clin Orthop Relat Res. 1988;(234):188-94.

Krettek C, Schandelmaier P, Tscherne H. Distal femoral fractures. Transarticular reconstruction, percutaneous plate osteosynthesis and retrograde nailing. Unfallchirurg. 1996;99(1):2-10.

Schatzker J, Lambert DC. Supracondylar fractures of the femur. Clin Orthop Relat Res. 1979;(138):77-83.

Rüedi TP, Murphy WM, Colton CL, Fackelman GE, Harder Y. AO principles of fracture management. Thieme Stuttgart. Rüedi TP, Murphy WM, Colton CL, Fackelman GE, Harder Y. AO principles of fracture management. Thieme Stuttgart. Germany. 2000.

Surulivel VJ, Ganesan GR, Rajasekeran R. Dynamic condylar screw versus supacondylar nail in the management of supracondylar fracture distal femur. Int Surg J. 2016;2(3):3736.

Thukral R, Marya SKS, Singh C. Management of distal femoral periprosthetic fractures by distal femoral locking plate: a retrospective study. Indian J Orthop. 2015;49(2):199-207.

Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. JBJS. 2007;89(10):2298-307.

Zlowodzki M, Williamson S, Cole PA, Zardiackas LD, Kregor PJ. Biomechanical evaluation of the less invasive stabilization system, angled blade plate, and retrograde intramedullary nail for the internal fixation of distal femur fractures. J Orthop Trauma. 2004;18(8):494-502.

Gellman RE, Paiement GD, Green HD, Coughlin RR. Treatment of supracondylar femoral fractures with a retrograde intramedullary nail. Clin Orthop Relat Res. 1996;332:90-7.

Sommer C. Biomechanics and clinical application principles of locking plates. Suom Ortop ja Traumatol. 2006;29:20-4.

Mize RD, Bucholz RW, Grogan DP. Surgical treatment of displaced, comminuted fractures of the distal end of the femur. J Bone Joint Surg Am. 1982;64(6):871-9.

Bolhofner BR, Carmen B, Clifford P. The results of open reduction and Internal fixation of distal femur fractures using a biologic (indirect) reduction technique. J Orthop Trauma. 1996;10(6):372-7.

Siliski JM, Mahring M, Hofer HP. Supracondylar-intercondylar fractures of the femur. Treatment by internal fixation. J Bone Joint Surg Am. 1989;71(1):95-104.

Jazrawi LM, Kummer FJ, Simon JA, Bai B, Hunt SA, Egol KA, et al. New technique for treatment of unstable distal femur fractures by locked double-plating: case report and biomechanical evaluation. J Trauma. 2000;48(1):87-92.

Koval KJ, Hoehl JJ, Kummer FJ, Simon JA. Distal femoral fixation: a biomechanical comparison of the standard condylar buttress plate, a locked buttress plate, and the 95-degree blade plate. J Orthop Trauma. 1997;11(7):521-4.

Canale TS, Beaty J. Fractures of the lower extremity. In: Campbell’s Operative Orthopaedics volume IV. 12th ed. Mosby. 2012;2690-702.

Yeap EJ, Ortho MS, Deepak AS, Ortho MS. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results. Malaysian Orthop J. 2007;1(1):12-7.

Kubiak E, Fulkerson E, Strauss E, Egol K. The Evolution of Locked Plates. J Bone Joint Surg Am. 2007;88(4):189-200.

Giannoudis P V, Schneider E. Principles of fixation of osteoporotic fractures. J Bone Joint Surg Br. 2006;88(10):1272-8.

Helfet DL, Haas NP, Schatzker J, Matter P, Moser R, Hanson B. AO philosophy and principles of fracture management-its evolution and evaluation. J Bone Joint Surg Am. 2003;85(6):1156-60.

Hernanz González Y, Díaz Martín A, Jara Sánchez F, Resines Erasun C. Early results with the new internal fixator systems LCP and LISS: a prospective study. Acta Orthop Belg. 2007;73(1):60-9.

Wagner M. General principles for the clinical use of the LCP. Injury. 2003;34(2):31-42.

Krishna C, Shankar R. Current concept of management of supracondylar femur fracture: retrograde femoral nail or distal femoral locking plate. Int Surg J. 2016;3(3):1356-9.

Singh S, Baghel PK, Rastogi D, Shantanu K, Sharma V. Distal femoral locked plating versus retrograde nailing for extra articular distal femur fractures: A comparative study. Int J Orthop Sci. 2018;4(4):702-5.

Agarwal S, Udapudi S, Gupta S. To Assess Functional Outcome for Intra-Articular and Extra-Articular Distal Femur Fracture in Patients using Retrograde Nailing or Locked Compression Plating. J Clin Diagnostic Res. 2018;12(3):21-4.

Yuan Y, Luo B, Hao Q, Yuan J, Qu G, Hao P, et al. Clinical outcomes of revision with retrograde intramedullary nailing for failed plating of distal femoral fractures: a retrospective study. Int Orthop. 2020;44(11):2437-42.

Magill H, Ponugoti N, Selim A, Platt J. Locked compression plating versus retrograde intramedullary nailing in the treatment of periprosthetic supracondylar knee fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2021;16(1):1-9.