Locking plate fixation versus antegrade intramedullary nailing for the treatment of extra-articular distal femoral fractures.

Abstract

The current study aimed to retrospectively analyze locked plating (LP) and antegrade intramedullary nailing (AIN) for the treatment of extra-articular distal femoral fractures. Between January 2000 and March 2015, 97 patients (49 male, 48 female) underwent surgery for extra-articular distal femoral fractures in our clinic. Patients were grouped based on their method of treatment (69 (71.1%) with locked plate (LP group) and 28 (28.9%) with antegrade intramedullary nailing (AIN group)), and the groups were analyzed with regards to fracture types, associated trauma, hospital stay, Injury Severity Score (ISS), nonunion, reoperation rate and Lysholm Functional Knee Score. The LP and AIN groups had no significant differences with regards to age and gender. Sixteen patients (16.4%) experienced nonunion; all of these (5 (5.1%) in the AIN group and 11 (11.3%) in the LP group) required a secondary procedure (p = 0.773). ISS was significantly higher in the AIN group (p = 0.033). There were no significant differences between the two groups with regards to hardware failure, postoperative malreduction, reoperation rate, deep infection, and nonunion. However, the AIN group (mean 88) had a significantly higher Lysholm Functional Knee Score than the LP group (mean 75.9) (p = 0.019). In our study we encountered less nonunion in AIN group. Both fixation methods offer good results; however, functional outcomes in the AIN group were significantly better than those in the LP group.