Objective: To evaluate the result of locking compressive plate in different types and severity of distal femoral fractures both clinically and radiologically.

Methods: 40 male and 10 female patients aged 18 to 85 (mean 39.9) years treated with locking compressive plate for distal femoral fracture. The causes of injury were vehicular accidents (n=45), falls (n=5). According to AO classification, the fracture were classified as type 33A1 (n=20), 33A2 (n=7), 33A3 (n=4), 33C1 (n=17), 33C2 (n=12) and 33C3 (n=1). Most fracture were closed (n=41); Gustilo- Anderson type I (n=4), type II (n=4), type III (n=1). Clinical and functional outcomes were assessed using “KNEE SOCIETY SCORE”.

Results: The mean time to union was 17.99 weeks. 60% of patients had knee flexion of more than 90 degrees. One osteoporotic women with Gustilo type I 33A1 had moderate occasional pain. At 6-month follow-up 42 had excellent and 7 had good results? One 33C2 fracture had poor result. Out of 30 intraarticular fracture 24 had excellent and 5 had good results? No patient developed malunion, nonunion or implant failure.

Conclusion: Locking compressive plate achieves favourable biological fixation for distal femoral fractures with few complications. Even with osteoporotic bone the distal end of plate never loosened. The outcome depends primarily on the etiology of the fracture, the severity of the injury, concomitant trauma, bone quality and early post-injury intervention, good surgical technique, anatomical reduction particularly in intraarticular fracture without varus and valgus collapse, stable biological fixation and early post-operative mobilization.