COMPARATIVE STUDY OF RETROGRADE DISTAL FEMORAL NAILING AND DISTAL FEMORAL PLATING IN EXTRA ARTICULAR DISTAL FEMUR FRACTURES
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Keywords
distal femur fractures, internal fixation, retrograde nailing, distal femoral locking plates
Abstract
Background: Distal femoral fractures are among challenging orthopedic injuries. Anatomical Distal Femoral locked plating and retrograde nailing are now method of choices of fracture fixation in such patients. Purpose of present study was to compare anatomical distal femur locked plating and retrograde intramedullary nailing for treatment of extra articular distal femur fractures.
Materials and Methods: A prospective randomized study including 38 patients of extra articular distal femur fractures was conducted in the Department of Orthopedic surgery. Patients were divided in two groups by random allocation. Patients of group I (20 patients) were treated by distal femoral locked plating and group II (18 patients) by retrograde distal femoral nailing using standard technique.
Results: The mean age of group I and group II were 52.5±16.8Years & 48.7±12.4 years respectively. The female – male ratio for both groups was matched (p=.075). The time of full weight bearing was significantly (p=0.004) less in nailing group. Bone union was seen earlier in group II (DFN) and it came to be statistically significant (p value-0.0006). Knee pain was present in 42.86% of patients in group II and it came out to be statistically significant (p<0.001). At the end of 1-year, Functional outcome assessed by Neer scoring system was statistically insignificant between the two groups, (group I 87.86%, group II 82.5%).
Conclusion: In our study functional results trended toward better outcomes in distal femoral nails than plates in terms of knee flexion, early weight bearing, less union time but incidence of knee pain is significantly higher in nailing group as compare to plating group.
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Vivek Phanswal
Associate Professor, Department of Orthopedics, GS Medical College, Hapur, Uttar Pradesh
Mohammad Shuaib
Assistant Professor, Department of Forensic Medicine, GS Medical College, Hapur, Uttar Pradesh