IJOCP | July 2017 | Volume 2017 | Issue 2017 | Page 124

Conference: EFORT – 2017, Vienna, Austria [Click for full details] 

Authors: Mohammad Abdelaal, Ahmed Elgammal, Bilal El Yafawi

Authors Affiliations: Rashid Hospital, Dubai, United Arab Emirates.

Address of correspondence: Dr.Mohammad Abdelaal, Rashid Hospital, Dubai, United Arab Emirates. E-mail: abdelaal@outlook.com


Abstract
 
   
                                                                                      

Background
Fractures of the distal third of the femur are a treatment challenge despite new fixation options. Fixed angle locking plates and intramedullary nails have become the most commonly used devices for this indication replacing blade plates and condylar screws. While both techniques are considered standard, few clinical studies have directly compared locked plates to nails. We seek to elucidate the respective
advantages and disadvantages of each technique in a randomized trial.

Objectives
The aim of this study is to compare clinical and radiological outcomes of retrograde intramedullary (RIN) nailing and locking compression plate (LCP) for treating distal femoral fractures.

Study Design & Methods
A prospective study of 30 patients with distal femoral fractures for comparison between fixation with retrograde intramedullary nails (RIN) and distal locked compression plates (LCP) from May 2014 to March 2016. The series included 15 cases treated with femoral retrograde interlocking nails (RIN) and 15 cases treated with distal femoral locked compression plates. The AO/OTA classification was used to grade the fractures .Follow-up visit at 2, 6 weeks, 3 months till union confirmed, and then every 6  months. At each visit, patients were examined clinically and radiologically. The results were rated according to the Sanders functional score. Inclusion criteria were: Skeletally mature, fractures with and without intra-articular extension (AO/OTA Types A1-3 and C1) .Exclusion criteria: AO/OTA Types B, C2 and C3 fractures and open fractures. mean age was 45 years ( range 24-85 year) in nailing group and 53 years ( range 20-77 years ) in the LCP group.In the nailing group, 8 were males and 7 were females
while in the plating group 9 males and 6 females.In the nailing group, 7 cases were right and 8 were left sided.In the LCP group ,10 cases were right sided and 5 left sided.

Results
Clinical and radiographic evaluation according to the functional score of Sanders demonstrated that in RIN group; 1case (6.6%) was Excellent, 9 cases were Good (60%), 4 cases were Fair (26.8%). While in LCP group; 8 cases were Good (53.2%), 4 cases were Fair (26.8%) and 3 cases were Poor (20%). In RIN group, the average time of fracture union was 19.5 weeks with a range of 12 to 28 weeks. Out of 15 cases; 14 cases (93.4%) progressed to union, one case (6.6%) had delayed union and need dynamization. In LCP group,the average time was 27.65 weeks with a range of 12 to 32 weeks. Out of 15 cases; 12 cases (80%) progressed to full union, 1 case (6.6%) had nonunion, and 2 cases (13.4%) of delayed union.

Conclusions
Both femoral retrograde interlocking nail and locked compression plate of distal femur appear to have statistically insignificant differences regarding knee motion, pain, resuming function and rate of 2nd surgery. However, retrograde nail is preferable to locked plate in terms of operative time, blood loss, as well as early appearance of callus, weight bearing, and shorter time required for full union.

Keywords: 

Tight Rope Technique, Acromioclavicular Joint Dislocation, Reconstruction, Surgery

How to Cite this Abstract
Abdelaal M, Elgammal A,  El Yafawi B. Retrograde IMN Versus Locked Compression Plating In Fixation Of Distal Femur Fractures,Comparative Study. International Journal of Conference Proceedings December 2016;(2016):124