This study aimed to compare the clinical outcomes of retrograde intramedullary nailing combined with a lateral locking plate versus dual plating (medial and lateral locking plates) in the treatment of AO/OTA 33C distal femoral fractures. A retrospective analysis was conducted on 78 patients treated between June 2017 and December 2022. Patients were divided into two groups: the nail-plate group (n = 42) and the dual-plate group (n = 36). Outcome measures included intraoperative blood loss, operative time, time to weight-bearing, bone union time, visual analogue scale (VAS) scores, hospital for special surgery (HSS) scores at final follow-up, knee range of motion (ROM), and complication rates. No significant differences were observed between the groups in terms of blood loss, operative time, time to weight-bearing, bone healing time, or follow-up duration (P > 0.05). Final follow-up assessments revealed no significant differences in VAS scores, HSS scores, or knee ROM (P > 0.05). The nail-plate group experienced five complications: one delayed union, two infections, one case of knee stiffness, and one case of limb shortening. The dual-plate group reported six complications: one delayed union, one nonunion, one infection, one case of knee stiffness, one malalignment, and one case of limb shortening. Complication rates did not differ significantly between groups (P > 0.05). No implant failures were observed in either group. Both fixation strategies provided stable constructs, facilitated early recovery, and resulted in satisfactory functional outcomes. Retrograde intramedullary nailing with lateral plating and dual plating are both effective options for the management of complex AO/OTA 33 C distal femoral fractures.
Xu et al. (Thu,) studied this question.