Babol University of Medical Sciences Caspian Journal of Surgery 3115-9087 1 3 2025 09 01 Comparison of Clinical Outcomes of Dynamic Compression Plate Versus Locked Intramedullary Nailing in the Treatment of Femoral Shaft Fractures: A Retrospective Cohort Study 142 150 730860 10.22088/caspjs.2025.2069453.1033 EN Atefe Charkazi Student Committee Research, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 0009-0004-3929-7988 Mani Falsafi Department of Orthopedic Surgery, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. 0000-0003-4292-0211 Ali Bijani Social Determinats of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 0000-0003-2233-8726 Mehdi Tavassoli Clinical Research Development Unit of Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, I.R. Iran 0000-0001-7790-9237 Journal Article 2025 08 22 Background: Femoral shaft fractures are among the most challenging orthopedic injuries, often necessitating surgical fixation. Although dynamic compression plating (DCP) and locked intramedullary nailing (IMN) are both standard options, their comparative outcomes in closed, non-comminuted fractures remain debated. This study aimed to compare the clinical outcomes and complications of IMN versus DCP fixation in adult patients with mid-shaft femoral fractures.<br><br>Methods: This retrospective cohort study included 40 adults with closed, non-comminuted mid-shaft femoral fractures treated at Shahid Beheshti Hospital, Babol, Iran (2022–2024). Twenty patients underwent IMN and 20 underwent DCP fixation. Demographic, intraoperative, and postoperative data—including infection, nonunion, fixation failure, intraoperative blood loss, hospitalization duration, and knee range of motion (ROM)—were extracted from medical records. Outcome definitions followed CDC and AO standards.<br><br>Results: Patients in the IMN group were significantly older than those in the DCP group (32.55 ± 20.74 vs. 19.90 ± 15.96 years; p = 0.037). Operative time was longer for IMN (191.25 ± 29.95 min) compared with DCP (151.00 ± 31.23 min; p < 0.001). No statistically significant differences were found between groups in infection (p = 0.465), nonunion (p = 1.000), fixation failure (p = 1.000), ROM (p = 0.300), blood loss (p = 0.428), or hospitalization duration (p = 0.832).<br><br>Conclusion: Both IMN and DCP provided similar short-term outcomes for closed femoral shaft fractures. However, due to the small sample and retrospective design, these findings are preliminary. Larger, prospective randomized trials are needed to confirm the results and guide optimal surgical decision-making. https://www.caspjs.com/article_730860_904fa4d3e34a785dd29e3d817c4d1171.pdf