Meta-Analysis Of Postoperative Complications In Distal Femoral Fractures: Retrograde Intramedullary Nailing Versus Plating

Background: With advances in surgical techniques of retrograde intramedullary nailing and plating for distal femoral fractures, conclusions regarding the superior choice remain controversial. This meta-analysis aimed to quantitatively investigate postoperative complications in a comparison of retrograde intramedullary nailing and plating for distal femoral fractures. Methods: The following electronic databases were searched before December 2015: PubMed, Science Direct, Wiley Online Library, and Google Scholar. All prospective and retrospective controlled trials comparing postoperative complications of retrograde intramedullary nailing and plating for distal femoral fractures were identified. The present meta-analysis was undertaken using RevMan 5.3 software. Results: Six studies with a total of 279 patients were eligible for data extraction in our meta-analysis. The pooled analysis showed no significant differences in infection, non-union, malunion, delayed union, metalwork failure, knee stiffness, and knee pain. While subgroup analysis indicated that the dynamic condylar screw plate group had significantly more intraoperative blood loss than the retrograde intramedullary nailing group, the locking-plate fixation group had significantly less intraoperative blood loss than the retrograde intramedullary nailing group. Conclusion: No implant is superior to any other under all circumstances for distal femoral fracture. The available evidence has shown that retrograde intramedullary nailing and plating have similar postoperative complication rates.