Materials and Methods:120 patients with C type distal femur fractures (mostly type C2 and C3) were treated with distal femur locking compression plate (DF-LCP), 60 using swashbuckler approach and 60 using standard lateral approach, were included in the study. The clinical outcome at 1 year was determined using the Neer’s Score.

Results: All fractures united at a mean of 14.64 weeks (range 12-20 weeks). In our study mean duration of surgery for lateral approach group was greater (99.6min) than swashbuckler group (85min).There were no significant complications such as nonunion, deep infection, and implant failure. Mean ROM in swashbuckler group was 100.83 degree compared to 83.83 in lateral group. Mean Neer’s score was 76.96 in lateral approach group compared to 81.83 Neer’s score in swashbuckler approach. Excellent results were seen in 19 cases (63.3%) in swashbuckler group as compared to 13 cases (43.3%) in lateral approach group.

Conclusion: The results of complex C type distal femur fractures, fixed with a single distal femur locking compression plate (DF-LCP) using a swashbuckler approach as compared to standard lateral approach are affirmative and comparable with a majority of patients achieving good to excellent outcome at 1 year especially in complex C3 fractures.