A Prospective Comparative Interventional Study for Management of Distal Femur Fractures-Open Reduction and Internal Fixation by Distal Femur Locked Plate Versus Retrograde Nailing in the Department of Orthopedics, SMS Medical College, Jaipur

Background: Extra-articular distal femur fractures require stable fixation for optimal functional recovery. This study compares Retrograde Intramedullary Nailing (RN) and Locking Compression Plate (LCP) fixation techniques in terms of operative parameters, healing, complications, and functional outcomes. Methods: In this prospective randomized study, 70 patients were equally assigned to two groups: RN (Group A) and LCP (Group B). Operative time, blood loss, radiological union, complications, and functional outcomes were evaluated over a 6-month period using the American Knee Society Score (AKSS) and knee range of motion (ROM). Data were analysed using unpaired t-tests. Results: The RN group had significantly shorter operative time (93.57 ± 10.07 vs. 98.65 ± 10.45 min; p = 0.042) and less blood loss (252.62 ± 34.46 vs. 313.57 ± 50.56 mL; p < 0.00001). Radiological union was achieved in all patients, with comparable union times (p = 0.101). Functional outcomes favoured RN, with higher AKSS (86.34 ± 10.35 vs. 81.17 ± 9.15; p = 0.030) and greater ROM (119.85° ± 21.11 vs. 110.05° ± 18.85; p = 0.044). Complications were minor: 3 infections (1 RN, 2 LCP) and 2 delayed unions (1 per group); no non-unions were observed. Conclusion: Both RN and LCP are effective for managing distal femur fractures, but RN offers superior surgical efficiency and functional recovery with a low complication rate. RN may be preferred in appropriately selected patients. Keywords: Distal femur fracture, retrograde nailing, locking compression plate, AKSS score, range of motion, complications.