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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Related Experiment Video

Updated: Jan 10, 2026

An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice

An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice

Published on: November 13, 2016

Nail Versus Plate for Distal Femur Fracture: A Propensity-matched Analysis.

Dane Brodke¹, Brian K Zukotynski, Sai Devana

¹From the Department of Orthopaedic Surgery, University of California, Los Angeles, CA (Zukotynski, Devana, Hernandez, and Lee), the Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD (O'Hara, Burke, Gupta, McKibben, and O'Toole), Department of Orthopaedic Surgery, University of Mississippi, Oxford, MS (Morellato, Gillon, and Walters), Department of Orthopaedic Surgery, Virginia Commonwealth University (Barber and Perdue), Richmond, VA, University of Utah, Salt Lake City, UT (Steffenson, and Marchand), Department of Orthopaedic Surgery, Los Angeles County Harbor-UCLA Medical Center, West Carson, CA (Fairres and Shymon), Department of Orthopaedic Surgery, Oregon Health & Science University (Brodke, Dekeyser, Black, and Working), the Department of Orthopaedic Surgery, University of California, San Francisco, CA (Roddy and El Naga), the Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA (Hogue and Gulbrandsen) and the Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX (Atassi, and Mitchell).

The Journal of the American Academy of Orthopaedic Surgeons

|November 21, 2025

Summary

Retrograde intramedullary nails and lateral locked plates showed similar outcomes for distal femur fractures. Treatment choice depends on surgeon experience and fracture characteristics, not implant superiority.

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Published on: October 12, 2016

Area of Science:

Orthopedic surgery
Traumatology
Biomedical engineering

Background:

Distal femur fractures are common injuries.
Treatment options include retrograde intramedullary nails and lateral locked plates.
Comparative outcomes between these single implant types are not well-established.

Purpose of the Study:

To compare revision surgery rates and clinical/radiographic outcomes.
To evaluate intramedullary nails versus lateral locked plates for distal femur fractures.

Main Methods:

Multicenter retrospective study of OTA/AO 33A or 33C distal femur fractures.
Propensity-matched cohorts of 245 intramedullary nail and 245 lateral plate cases.
Follow-up of at least 3 months, comparing revision rates and Radiological Union Scale for Tibia (RUST) scores.

Main Results:

No significant differences in all-cause revision surgery (24% vs. 19%), union revision (8.2% vs. 10%), or infection revision (5.7% vs. 5.7%).
Similar modified RUST scores at 3 months (9 vs. 9).
No notable differences in radiographic reduction, surgical duration, or qualitative outcomes.

Conclusions:

Retrograde intramedullary nails and lateral locked plates yield comparable results for distal femur fractures.
Implant selection should be guided by surgeon expertise, fracture pattern, and reduction ease.
Neither implant type demonstrated superior outcomes in this matched cohort study.