COMPARATIVE STUDY BETWEEN RESULTS OF RETROGRADE INTRAMEDULLARY NAILING (RN) VS LOCKED PLATING (LP) IN TREATMENT OF DISTAL FEMUR FRACTURES: A PROSPECTIVE ANALYSIS

Introduction: Distal femoral fractures are among challenging orthopaedic injury constituting 0.4% of all fractures. Despite recent evaluation in operating techniques and surgical implants, debate continues around the choice of implant for various type of distal femur fractures. Method and Material: In prospective randomized study from 2020 to 2022, analysis of 40 patients was done out of which 20 cases were treated in each group with follow-up at 2,6,12,24 weeks and 6 months. Results: Clinical and radiographic evaluation according to KOOS functional score demonstrated that in RL group, 3 case were excellent, 10 cases were good, 07 cases were fair, while in LP group: 01 case was excellent, 07 cases were Good and 11 cases were fair and 01 case was poor. Over 90% of fractures under RN and LP healed within 6 months with average time being 21.15 weeks (range 12 to 28 weeks) in RN and 23.30 weeks (range 12-32 weeks) in LP group. Out of 20 cases of RN group, 2 went for delayed union requiring dynamisation and in LP group 3 went for delayed union and 1 for nonunion. Conclusion: Mean KOOS score was found to be significantly better in RN group for type A fractures. However for type C fractures results were statistically insignificant. Difference for parameters, time to osseous healing, knee motion, pain, rate of second surgery, post-op complication etc were found to be statistically insignificant, proving both RN and LP as adequate options.