Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures

Abstract This study aimed to compare the clinical outcomes of retrograde intramedullary nailing combined with a lateral locking plate versus dual plating (medial and lateral locking plates) in the treatment of AO/OTA 33C distal femoral fractures. A retrospective analysis was conducted on 78 patients...

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Main Authors: Weizhen Xu, Weibin Lin, Hui Liu, Yuanfei Xiong, Jinhui Zhang, Jin Wu
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-14999-6
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author Weizhen Xu
Weibin Lin
Hui Liu
Yuanfei Xiong
Jinhui Zhang
Jin Wu
author_facet Weizhen Xu
Weibin Lin
Hui Liu
Yuanfei Xiong
Jinhui Zhang
Jin Wu
author_sort Weizhen Xu
collection DOAJ
description Abstract This study aimed to compare the clinical outcomes of retrograde intramedullary nailing combined with a lateral locking plate versus dual plating (medial and lateral locking plates) in the treatment of AO/OTA 33C distal femoral fractures. A retrospective analysis was conducted on 78 patients treated between June 2017 and December 2022. Patients were divided into two groups: the nail-plate group (n = 42) and the dual-plate group (n = 36). Outcome measures included intraoperative blood loss, operative time, time to weight-bearing, bone union time, visual analogue scale (VAS) scores, hospital for special surgery (HSS) scores at final follow-up, knee range of motion (ROM), and complication rates. No significant differences were observed between the groups in terms of blood loss, operative time, time to weight-bearing, bone healing time, or follow-up duration (P > 0.05). Final follow-up assessments revealed no significant differences in VAS scores, HSS scores, or knee ROM (P > 0.05). The nail-plate group experienced five complications: one delayed union, two infections, one case of knee stiffness, and one case of limb shortening. The dual-plate group reported six complications: one delayed union, one nonunion, one infection, one case of knee stiffness, one malalignment, and one case of limb shortening. Complication rates did not differ significantly between groups (P > 0.05). No implant failures were observed in either group. Both fixation strategies provided stable constructs, facilitated early recovery, and resulted in satisfactory functional outcomes. Retrograde intramedullary nailing with lateral plating and dual plating are both effective options for the management of complex AO/OTA 33 C distal femoral fractures.
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spelling doaj-art-e1e9aae8bbe749d0bf8412a4b394f7922025-08-20T04:02:45ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-14999-6Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fracturesWeizhen Xu0Weibin Lin1Hui Liu2Yuanfei Xiong3Jinhui Zhang4Jin Wu5Department of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityDepartment of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityDepartment of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityDepartment of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityDepartment of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityDepartment of Orthopaedics, the 909th Hospital, School of Medicine, Xiamen UniversityAbstract This study aimed to compare the clinical outcomes of retrograde intramedullary nailing combined with a lateral locking plate versus dual plating (medial and lateral locking plates) in the treatment of AO/OTA 33C distal femoral fractures. A retrospective analysis was conducted on 78 patients treated between June 2017 and December 2022. Patients were divided into two groups: the nail-plate group (n = 42) and the dual-plate group (n = 36). Outcome measures included intraoperative blood loss, operative time, time to weight-bearing, bone union time, visual analogue scale (VAS) scores, hospital for special surgery (HSS) scores at final follow-up, knee range of motion (ROM), and complication rates. No significant differences were observed between the groups in terms of blood loss, operative time, time to weight-bearing, bone healing time, or follow-up duration (P > 0.05). Final follow-up assessments revealed no significant differences in VAS scores, HSS scores, or knee ROM (P > 0.05). The nail-plate group experienced five complications: one delayed union, two infections, one case of knee stiffness, and one case of limb shortening. The dual-plate group reported six complications: one delayed union, one nonunion, one infection, one case of knee stiffness, one malalignment, and one case of limb shortening. Complication rates did not differ significantly between groups (P > 0.05). No implant failures were observed in either group. Both fixation strategies provided stable constructs, facilitated early recovery, and resulted in satisfactory functional outcomes. Retrograde intramedullary nailing with lateral plating and dual plating are both effective options for the management of complex AO/OTA 33 C distal femoral fractures.https://doi.org/10.1038/s41598-025-14999-6Distal femoral fracturesRetrograde intramedullary nailLateral locking plateDual plate fixationAO/OTA classification
spellingShingle Weizhen Xu
Weibin Lin
Hui Liu
Yuanfei Xiong
Jinhui Zhang
Jin Wu
Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
Scientific Reports
Distal femoral fractures
Retrograde intramedullary nail
Lateral locking plate
Dual plate fixation
AO/OTA classification
title Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
title_full Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
title_fullStr Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
title_full_unstemmed Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
title_short Comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of AO/OTA 33C distal femoral fractures
title_sort comparison of combined femoral nail and plate fixation versus dual plate fixation in the treatment of ao ota 33c distal femoral fractures
topic Distal femoral fractures
Retrograde intramedullary nail
Lateral locking plate
Dual plate fixation
AO/OTA classification
url https://doi.org/10.1038/s41598-025-14999-6
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