Early ambulation and good outcomes after using combined nail plate construct for fixation of distal femoral fractures: a retrospective series of 14 cases.

Background: Combined nail/plate technique is a relatively novel method for surgically managing distal femur fractures. It was supposed to allow for early weight bearing and achieve adequate fixation that allow for good bone healing. This study aims to describe our single institution experience of treating distal femur fractures using the combined nail/plate technique.

Methodology: This is a retrospective study of 14 cases who had AO/OTA fractures 33A_C that were managed with this technique. Patients mean age was 67.6 years and all of them had either obvious osteopenia/osteoporosis or comminuted fractures.

Results: With early postoperative weight bearing, after a mean follow up of 13.2 months, all the patients were able to return to preinjury activity level. None of the cases were revised for union related problems. Adequate bone healing was noticed after a mean of 16.8 weeks postoperatively. At the final follow up, the mean Oxford knee score was 42 (range 34-46).

Conclusion: The combined nail/plate technique provides adequate fixation method that allows for early weight bearing and good functional outcomes. More studies, ideally comparative are needed to properly assess the cost benefit of this technique compared to other techniques.