الفهرس 
Relevant AnatomyOnly 14 pages are availabe for public view
 |  | from | 123 |  |  |
| | | from | 123 | | |
Abstract
Background: Extra-articular Distal femoral fractures remain a challenging matter due to the high energy trauma causing the injury and the association with soft tissue injury, vascular injury and physical disability. Different methods of fixation exist depending on a lot of factors; patient related factors, type of fractures, surgeon’s preferences.
Aim of the Work: to evaluate the outcome & complications of retrograde intramedullary nailing versus locked plating in management of extra-articular distal femur fractures.
Patients and Methods: The standard method of management of extra-articular distal femur fractures including either internal fixation by intramedullary nailing (Antegrade or Retrograde) or distal femur locked plate (LP).
Results: Retrograde nailing shows superiority over the Antegrade nailing especially the very distal fractures and the associated intra-articular extension. However every methods comes with its own advantage and disadvantage. Retrograde nailing gaining its popularity due to minimal insertion point and maintaining the fracture hematoma. Distal femur locked plate witnessed a lot of development including; multidirectional locking mechanism which comes very handy especially with osteoporotic bone and intra-articular extension; also the development of minimally invasive percutaneous osteosynthesis technique and system reducing time, blood loss and soft tissue dissection.
Conclusion: The present review shows lesser mean fracture union time and a lesser overall complication favoring the Retrograde Intramedullary Nailing (RIMN) over the Locked Plating (LP). We didn’t find a statistical significant difference between the two groups in non-union, delayed-union, mal-union, knee stiffness, knee pain, superficial/deep infection; implant related complication, re-operation rate and duration of surgery. But a less intra-operative blood loss and a better post-operative knee range of movement was seen in the LP group. Both the options of fixation appear to be feasible options, and specific indications should be considered for making the final choice