Evidence map›Paper›PMID 40823279›Full record

ArticleOrthopedic reviews2025

Retrograde Intramedullary Nailing vs. Lateral Locking Plate Fixation for Distal Femur Fractures: Which Technique is Superior?

İsmail Güzel, Tarık Altunkılıç, Bünyamin Arı, Mehmet Boz

Abstract read
In one paragraph

Article in Orthopedic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

İsmail GüzelDepartment of Orthopedics and Traumatology Malatya Turgut Özal Üniversitesi.ORCID https://orcid.org/0000-0003-2740-4139
Tarık AltunkılıçDepartment of Orthopedics and Traumatology Malatya Turgut Özal Üniversitesi.ORCID https://orcid.org/0000-0002-1640-4275
Bünyamin ArıDepartment of Orthopedics and Traumatology Malatya Turgut Özal Üniversitesi.ORCID https://orcid.org/0000-0001-9720-1869
Mehmet BozDepartment of Orthopedics and Traumatology Malatya Turgut Özal Üniversitesi.ORCID https://orcid.org/0000-0003-0710-6978

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Distal femur fractures are challenging to treat, especially in elderly osteoporotic patients. Retrograde intramedullary nailing (RIMN) and lateral locking plate (LP) fixation are commonly used surgical methods for these fractures. This study aimed to compare the clinical and radiological outcomes of these two techniques. Methods: In this retrospective study, a total of 72 patients with distal femur fractures classified according to the AO/OTA system and treated surgically were included. Patients were divided into two groups: RIMN (n=36) and LP (n=36). Demographic data, fracture classification, surgical method, operative time, intraoperative blood loss, early weight-bearing status, knee range of motion, union time, and complication rates were evaluated. Additionally, union rate, infection, implant failure, and reoperation requirement were compared. A power analysis was conducted assuming 70% power to detect a clinically significant difference. Statistical analyses included T-test, Mann-Whitney U test, Chi-square test, and Fisher's exact test. Kaplan-Meier analysis was used to assess union time. A p-value <0.05 was considered statistically significant. Results: The union rate was 86.1% in the RIMN group and 75.0% in the LP group. The average union time was 15.4 weeks for RIMN and 17.2 weeks for LP. Knee range of motion was significantly better in the RIMN group (115.2° vs. 110.4°, p=0.03). Early weight-bearing was achieved in 61.1% of RIMN patients and 44.4% of LP patients (p=0.11). The overall complication rate was 16.7% in the RIMN group and 25.0% in the LP group. Infection rates were 5.6% and 8.3%, respectively. Implant failure was observed in 5.6% of patients in both groups. Reoperation was required in 8.3% of RIMN and 13.9% of LP patients. Conclusion: Our findings suggest that RIMN may offer advantages over LP in terms of higher union rates, shorter union time, and better functional outcomes, particularly in osteoporotic patients. However, both techniques demonstrated acceptable complication rates, and treatment choice should be tailored to the fracture pattern and patient characteristics. Further prospective, randomized studies are needed to support these findings.

Indexed as

ComplicationsDistal femur fractureIntramedullary nailingLocking plateOsteoporotic fracturesSurgical treatmentUnion rate

Identifiers

PMID40823279
PMCPMC12351506

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.