Retrograde Intramedullary Nailing Versus Locking Plate Fixation in Distal Femur Fractures: Comparative Functional Outcomes
Keywords:
distal femur fracture; retrograde intramedullary nail; locking plate fixation; Knee Society Score; fracture union; complication rate; AO/OTA classificationAbstract
Background: Distal femur fractures (DFF) are challenging injuries with two dominant surgical strategies: retrograde intramedullary nailing (RIMN) and locking plate (LP) fixation. Optimal technique selection remains debated. Objective: To compare functional outcomes and complication profiles of RIMN versus LP in DFF patients treated at Fergana Regional Multidisciplinary Hospital. Methods: Sixty-eight patients with AO/OTA 33A-C fractures were allocated to RIMN (Group A, n=34) or LP fixation (Group B, n=34). Outcomes included Knee Society Score (KSS), fracture union time, range of motion (ROM), and complication rates over 12 months. Results: Group A had significantly shorter operative time (82.4 vs 104.7 min), lower blood loss (148 vs 213 mL), and faster union (15.8 vs 17.2 weeks). Group B achieved superior knee ROM at 12 months (118.2° vs 110.4°). KSS was comparable between groups. Complication rate favored RIMN (8.8% vs 20.6%). Conclusion: RIMN offers perioperative advantages and lower complication rates, while LP confers superior knee flexion recovery. Implant selection should be individualized based on fracture morphology and patient factors.
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