Internal fixation treatment mode choices for the complex distal femoral fractures

Objective To compare the efficacy and indication of the two different kinds of internal fixation treatment modes for the complex distal femoral fractures.Methods Reviewing the clinical data of 46 cases used two kinds of internal surgical treatment of complex distal femoral fracture during Jan 2006 to Mar 2009.These cases including 28 males and 18 females with an average age of 42.9-year-old ranging from age 26~71 years were divided into 2 groups:retrograde intramedullary nail group(A-Group,20 cases);pressure locking plate fixation group(B-Group,26 cases).There were all complex fracture types according X-ray film by AO/ASIF classification(A3、C2、C3).Results All patients were followed up for 16~36 months(average 24 months)and obtained first intention incisions healing and satisfied replacement without complications such as postoperative infection,implant rupture,nonunion of bone,deep vein thrombosis,limb shortening,varus deformity.Fracture healing time was 15~20 weeks,the A-Group in average 18.18 weeks and the B-Group in average 18.38 weeks,between the two groups showed no significant difference(P0.05).Postoperative knee scoring according to merchan system.A-Group:excellent in 11 cases,better in 6 cases,good in 2 cases and poor in 1 case,fine rate was 85.0%.B-Group:excellent in 15 cases,better in 8 cases,good in 2 cases and poor in 1 case,fine rate was 88.5%.Difference between the two groups was statistically significant(P0.05).Conclusion For the complex distal femur fractures,retrograde intramedullary locking nail and compression plate could achieve good results.However,the results of our observations,using locking compression plate system could to minimize soft tissue damage,the recovery of knee function seems better than using retrograde intramedullary nail system.