Functional and Radiological Outcomes of Midline versus Separate Incision Approaches in Distal Femur Fixation: A Comparative Prospective Study

Background: Distal femur fractures are complex injuries that demand accurate anatomical reduction and stable fixation to restore knee function. Surgical approach plays a critical role in outcomes, particularly regarding soft-tissue preservation. The choice between a midline approach and a separate incision technique remains controversial due to variations in exposure, tissue handling, and complication rates. Materials and Methods: This prospective comparative study will include 30 patients diagnosed with distal femur fractures. Participants will be randomly allocated into two groups: 15 patients undergoing fixation through a midline approach and 15 through a separate incision approach. Functional outcomes will be assessed using the Knee Society Score, whereas radiological outcomes, including fracture union and alignment, will be evaluated over a follow-up period of 6–12 months. Results: The separate incision approach is anticipated to demonstrate superior soft-tissue healing, reduced infection rates, and comparable fracture union rates. Although the midline approach may provide improved surgical visualization, it is expected to be associated with a higher incidence of wound-related complications. Conclusion: Both surgical approaches are effective for managing distal femur fractures; however, the separate incision technique may offer advantages in minimizing soft tissue damage and reducing postoperative complications.