Comparative Study of Locking Compression Plate versus Intramedullary Nail in Distal Femur Fracture

Open Access

Abstract

Introduction: Distal femur fractures are complex injuries that can occur from high-energy trauma in young adults or low-energy falls in the elderly. Surgical fixation is the standard approach to restoring alignment, allowing early mobilisation, and achieving good functional outcomes. The two most common methods are Locking Compression Plate (LCP) and Intramedullary Nailing (IMN). This study aimed to compare the clinical, radiological, and functional outcomes of Locking Compression Plate versus Intramedullary Nailing in patients with distal femur fractures. Methods & Materials: This comparative observational study was conducted in the Department of Orthopedics, Satkhira Sadar Hospital, Satkhira, Bangladesh from January 2024 to January 2025. A total of 68 patients diagnosed with distal femur fractures (AO/OTA type 33) were enrolled based on predefined inclusion and exclusion criteria. Data were analysed using SPSS software version 25.0. Result: In our study of 68 distal femur fracture patients (34 treated with Locking Compression Plate (LCP) and 34 with Intramedullary Nailing (IMN)), IMN resulted in significantly shorter operative time, less intraoperative blood loss, and faster radiological union (mean 15.9 vs. 18.7 weeks, p = 0.004). Functional outcomes (knee motion, pain, walking ability) at 6 months were slightly better in the IMN group, though not statistically significant. Complication rates— including infection, implant failure, non-union, and knee stiffness — were roughly similar between groups. Conclusion: IMN was associated with shorter operative time, less blood loss, and faster union, while LCP offered better stability for comminuted or intra-articular fractures with slightly superior early functional outcomes.