A Combined Nail-Plate Construct Fixation in Treatment of Distal Femoral Fractures | ||
| Medicine Updates | ||
| Articles in Press, Accepted Manuscript, Available Online from 22 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/muj.2025.427862.1267 | ||
| Authors | ||
| Hazem Khaled Sabry* ; Ashraf Abdelaziz Mahmoud; Mohamed Eltabey ElGritly | ||
| Department of Orthopedic Surgery, Faculty of Medicine, Port Said University | ||
| Abstract | ||
| Background: Distal femur fractures remain challenging to manage, particularly in osteoporotic and comminuted patterns. The nail–plate construct (NPC) has emerged as a hybrid fixation technique combining the biomechanical advantages of retrograde intramedullary nailing and lateral plating. Methods: We conducted a prospective study of 15 patients (mean age 52.4 years, range 18–80; 53.3% female) with AO/OTA 33A and 33C1 distal femur fractures treated using NPC between May 2024 and May 2025. Primary outcomes included radiographic union and functional recovery assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 and 6 months. Secondary outcomes included operative details and complications. Results: All patients achieved radiographic union (100%), with a mean union time of 15.5 weeks. Distribution of union was 60% by 12 weeks, 20% by 16 weeks, 13.3% by 20 weeks, and 6.7% at 36 weeks (delayed union). KOOS scores improved significantly from baseline (38.7) to 62.4 at 3 months (p < 0.01) and 78.3 at 6 months (p < 0.001). Mean operative time was 107 minutes and mean intraoperative blood loss was 720 mL. Complications were limited to one superficial infection (6.7%) and one delayed union (6.7%), with no implant failures, malalignment, or reoperations. Conclusion: Nail–plate construct fixation demonstrated reliable union, excellent early functional outcomes, and low complication rates in distal femur fractures. The technique may offer a biomechanically advantageous alternative to single-implant constructs, warranting further validation in larger multicenter trials. | ||
| Keywords | ||
| distal femur fractures; nail–plate construct; hybrid fixation; KOOS; outcomes | ||
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