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Related Experiment Video

Updated: Aug 30, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner

Published on: June 6, 2025

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Locked Lateral Plating Versus Retrograde Nailing for Distal Femur Fractures: A Multicenter Randomized Trial.

Robert P Dunbar1, Kenneth A Egol2, Clifford B Jones3

  • 1Department of Orthopaedics and Sports Medicine, Harborview Medical Center/University of Washington, Seattle, WA.

Journal of Orthopaedic Trauma
|August 26, 2022
PubMed
Summary

Locked lateral plating and retrograde nailing show similar functional outcomes for distal femur fractures. Patients experience ongoing impairment one year post-surgery, regardless of treatment method.

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Area of Science:

  • Orthopedic surgery
  • Trauma management
  • Biomechanical engineering

Background:

  • Distal femur fractures are complex injuries requiring effective surgical intervention.
  • Locked lateral plating and retrograde intramedullary nailing are primary treatment modalities.
  • Comparative outcome data is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the functional outcomes of locked lateral plating versus retrograde intramedullary nailing for distal femur fractures.
  • To evaluate secondary outcomes including alignment, operative time, and adverse events.

Main Methods:

  • Multicenter randomized controlled trial involving 160 patients with distal femur fractures.
  • Randomization to either locked lateral plating (62 patients) or retrograde intramedullary nailing (64 patients).
  • Follow-up at 12 months with functional assessments (SMFA, bother index, EQ-5D) and radiographic evaluation.

Main Results:

  • No significant functional differences were observed between plating and nailing groups at 12 months.
  • Both treatment groups showed persistent functional deficits one year post-injury.
  • Adverse event rates and types were comparable between the two surgical interventions.

Conclusions:

  • Both locked lateral plating and retrograde intramedullary nailing are viable surgical options for distal femur fractures.
  • Patient recovery is progressive but incomplete at one year, irrespective of surgical technique.
  • Further research may explore long-term functional trajectories and patient-reported outcomes.