Surgical and Functional Outcomes of Distal Femur Fractures Operated With Distal Femur Locking Compression Plate Versus Intramedullary Supracondylar Nail

Introduction Distal femur fractures are common but challenging as they are usually displaced and comminuted. They are prone to functional impairment of the knee joint because of injury to the quadriceps system. Such fracture often occurs in elderly patients with osteoporosis. Various treatment methods, such as closed traction, application of a cast brace following preliminary traction, and open reduction with internal fixation using various implants, are suggested. We evaluated the surgical and functional results of distal femur fractures treated with anatomical distal femur locking compression plate (DFLCP) versus intramedullary supracondylar nail (IMSCN). Materials and methods The study was conducted from April 2023 to August 2024. We included 20 patients with distal femur fractures, who were planned to be operated on with DFLCP or IMSCN. They were followed up for at least six months. Surgical and functional outcomes were analyzed as per the Schatzker and Lambert criteria. Results DFLCP was preferred for inter-condylar (intra-articular) distal femur fractures. The average blood loss for the DFLCP group was 425 ml, and for the IMSCN group, it was 242.85 ml. The functional outcomes were comparable for both groups. The average union time for the DFLCP group was 8.15 months, and for the IMSCN group, it was 7.15 months. We analyzed the results by the Schatzker and Lambert criteria. We achieved 46% and 42.85% excellent results in plate v/s nail groups, respectively. Conclusions DFCLP is a better implant for inter-condylar, i.e., intra-articular and highly comminuted distal femur fractures. It gives anatomic and stable fixation. The average intraoperative blood loss is higher with DFLCP. The average union time is less with the IMSCN. Closed reduction, preserving fracture hematoma, and less soft tissue compromise result in early fracture union in IMSCN. Soft tissue compromise in open grade 3B fractures affects the functional outcomes. The final results do not change with the use of DFCLP or IMSCN.