Choice of internal fixation treatment for the complex distal femoral fractures

[Objective]To compare the efficacy and indication of two different internal fixation methods for the complex distal femoral fracture.[Method]Forty-six cases of complex distal femoral fracture were treated with 2 internal surgical fixations,with 28 males and 18 females,and with average age of 42.9 years(range,26-71 years).All cases were divided into 2 groups: retrograde intramedullary nail group(group A,20 cases),pressure locking plate fixation group(group B,26 cases).They were confirmed as complex fracture according to X-ray film by AO/ASIF classification(A3,C2,C3).[Result]All patients were followed up for 16-36 months(average,24 month).All patients obtained first intention incision healing and satisfactory replacement without complications such as postoperative infection,implant repture,nonunion of bone,deep vein thrombosis,limb shortening,varus deformity.Fracture healing time was 15-20 weeks,18.18 weeks in group A,18.38 weeks in group B,without signifiant difference(P0.05).According to Merchan classification system,there were 11 excellent results,6 good results,2 fair results and 1 poor result in group A,with goo to excellent rate of 85.0%.There were 15 excellent results,8 good results,2 fair results and 1 poor result in group B.There were fignificant difference between 2 groups(P0.05).[Conclusion]For the complex distal femoral fracture,both retrograde intramedullary locking nail and compression plate could achieve good results.However,locking compression plate system has good effect of knee functional recovery and more extensive indications than using retrograde intramedullary nail system,so it is more commonly used in clinical