Comparison Of Retrograde Intramedullary Nail And Locking Plate Fixation For Distal Femoral Fractures

Objective To compare the effectiveness of retrograde intramedullary nail(RIN) and locking plate(LP) in the treatment of distal femoral fractures, and explore the ideal fixation method in the treatment of distal femoral fractures.Materials and methods 1.Research object: We retrospectively analyzed 54 patients with distal femoral fractures from February 2007 to March 2014.They were aged from 20 to 86 years(average,54.6 years). Of them,28 were fixated with RIN and 26 with LP. 2.Observation index: a. Preoperative general information: gender, age, type of fracture, the causes of injury, waiting time from injury to operation. b. Intraoperative information: operative time, intraoperative bleeding loss. c. Postoperative follow‐up data:The fracture healing time and the excellent and good rate of knee function, according to Kolmert score of knee function. 3.Statistical analysis: Uses SPSS19.0 statistical software, measurement data with` x ±S said, using t test, count data using X2 test. To evaluate the curative effect of comparison between 2 groups, with P<0.05 as statistically significant difference.Results The 54 patients were followed up for 8 to 24 months(average,12.8 months).All patients had normal healing. 1.RIN group: The 28 patients were fixated with RIN, the waiting time before operation respectively were 5.68±2.67 days, the operative time respectively were 154.64±56.07 minutes, the intraoperative bleeding loss respectively were 388.57±170.77 m L. All patients are given follow‐up, there are 2 case with pain in the knee joint,there were no complications such as infection and intenal fixation loosening. The fracture healing time respectively were 22.54±2.95 weeks.According to Kolmert score of knee function:18 cases of excellent, 6 cases of good,4 cases of passable, 0 case of poor, the excellent and good rate was 85.7%. 2.LP group: The 26 patients were fixated with LP, the waiting time before operation respectively were 5.42±2.21 days, the operative time respectively were 131.73±72.99 minutes,the intraoperative bleeding loss respectiely were 403.85±242.46 m L. All patients are given follow‐up, there are 2 case with knee varus deformity and 1 case with deep vein thrombosis, there were no complications such as infection and interal fixation loosening. The fracture healing time respectively were 24.96±3.70 weeks. According to Kolmert score of knee function:16 cases of excellent, 5 cases of good,4 cases of passable, 1 case of poor, the excellent and good rate was 80.8%. 3.Statistical analysis results: There were no significant differences between the 2 groups in the indications of the operative time and the intraoperative bleeding loss, the excellent and good rate of knee function(P>0.05). The fracture healing time in RIN group were 22.50±3.32 months in RIN group, and 22.23±3.39 months in LP group. There was a significant difference in the indication of the fracture healing time between 2 groups(P<0.05).Conclusion As two methods to treat the distal femoral fractures, retrograde intramedullary nail is superior to locking plate in terms of fracture healingtime,though these two methods can both achieve satisfactory results in terms of functional recovery of knee.