Functional and Radiological Outcomes after Locking Compression Plate Fixation of Adult Distal Femur Fractures: A Prospective Observational Study

Abstract Background: Distal femoral fractures remain challenging injuries because stable fixation must be combined with accurate joint reconstruction, restoration of mechanical alignment, and timely knee mobilization. Objective: The objective of this study was to assess short-term functional and radiographic outcomes and treatment-related complications after distal femur locking compression plate fixation in closed adult distal femur fractures. Materials and Methods: This prospective observational study enrolled 32 adults with closed AO/OTA 33A, 33B, or 33C distal femur fractures treated with a distal femur locking compression plate at a tertiary teaching hospital from February 2021 to August 2022. Clinical and radiological assessment was performed at 6 weeks, 3 months, and 6 months using the Neer’s scoring system. Results: The mean patient age was 39.53 ± 10.46 years, and 20 patients (62.5%) were male. Road traffic accidents were responsible for 24 injuries (75.0%). AO/OTA 33C3 was the most common subtype (34.4%). At final follow-up, 21 patients (65.6%) had excellent, 9 (28.1%) good, and 2 (6.2%) fair outcomes; no patient had a poor final score. The combined excellent–good rate was 93.7%. The recorded complications were pain (16.7%), infection (13.3%), stiffness (13.3%), nerve injury (13.3%), myositis (3.3%), hardware prominence (3.3%), and nonunion (3.3%). Conclusion: Distal femur locking compression plate fixation achieved stable fixation with progressive functional and radiological recovery in closed adult distal femoral fractures. Outcomes depend on meticulous reduction, preservation of soft-tissue biology, appropriate construct planning, and supervised rehabilitation.