ArticleCureus2025
Management of Extra-articular Distal Femoral Fractures Through Closed Reduction and Internal Fixation Using Minimally Invasive Plate Osteosynthesis Versus Retrograde Intramedullary Nailing: A Comparative Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDistal femoral fractures (DFFs) account for a small proportion of femoral fractures and can be challenging to manage. The goal of treatment is to restore alignment, length, and function while minimizing soft-tissue disruption. Two common fixation options are minimally invasive plate osteosynthesis (MIPO) and retrograde intramedullary nailing (RIMN). This study prospectively compared the outcomes of both techniques in extra-articular DFFs. MATERIALS AND
methodsA prospective comparative study was conducted on 40 adult patients with extra-articular DFFs (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association 33-A (AO/OTA 33-A)). Patients were allocated to two treatment groups: MIPO (n = 20) and RIMN (n = 20) according to the surgeon's preference. Outcomes included time to radiological union and range of motion. Functional results were assessed using the Knee Society Score and Lysholm Knee Score at three and six months, and complications were recorded. Statistical analyses were performed using independent t-tests and Fisher's exact test, with significance set at p < 0.05.
resultsBoth groups showed significant functional improvement over time. At six months, good-to-excellent results were seen in 80% of MIPO and 85% of RIMN patients. RIMN patients achieved earlier full weight-bearing (average 6.2 weeks vs. 8.3 weeks; mean difference -2.1 weeks (95% CI -2.9 to -1.3; t(38) = -4.65, p < 0.001). and slightly better knee flexion at final follow-up (112° ± 7.5 vs 107° ± 8.2); mean difference 5.0° (95% CI 1.2 to 8.8; t(38) = 2.68, p = 0.011). However, anterior knee pain was more frequently reported after RIMN (20% vs. 5%), although this difference was not statistically significant (p = 0.342). Two superficial infections occurred in the MIPO group (10%). The mean time to union was 14.3 ± 1.9 weeks (MIPO) and 15.1 ± 2.1 weeks (RIMN); the mean difference was -0.8 weeks (95% CI -2.0 to 0.4; t(38) = -1.26, p = 0.214), and no reoperations were required. This prospective study adds focused evidence on extra-articular (AO/OTA 33-A) fractures, which remain underrepresented in comparative research.
conclusionsBoth MIPO and RIMN are reliable methods for extra-articular DFFs, providing comparable rates of union and excellent functional outcomes. While a broader range of final coronal alignment was observed in the RIMN group, this did not compromise stable union or functional recovery. RIMN offers faster rehabilitation and earlier weight-bearing, but with a higher reported incidence of anterior knee pain. MIPO is associated with lower knee morbidity and may be a suitable alternative, particularly for patients in whom minimizing anterior knee symptoms is a key concern, despite its slower rehabilitation pathway. The choice should be tailored to the fracture pattern, bone quality, and patient needs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.