Double-plating approach in the management of isolated distal femoral fractures

Background: Fractures above 9 cm of the articular surface of distal femur are defined as distal femoral fractures which accounts for an estimated 4%-6% of all femur fractures. Stable fixation can be achieved by dual plating of distal femoral fracture. The indications of a dual- lateral and medial plate medial are comminuted distal femur fractures (AO type C3), medial supra-condylar void and bone loss of more than 3 cm, medial Hoffa fracture, inter-condylar comminuted bicondylar fractures, non-union after failed fixation with single lateral plate, poor bone quality.Methods: The retrospective research study of 35 cases of distal femoral fractures which were treated with lateral and medial plates in post graduate institute Swasthiyog Pratishthan, Miraj (G. S. Kulkarni Hospital, Miraj). The study period was from September 2020 to May 2022. The average follow-up was 8 months.Results: 1 year after operation, knee function was evaluated by Oxford knee score along with Mean EQ-5D-5 L score. Functionally the mean oxford knee score was 41.53±1.69, with a maximum Oxford Knee Score of 48. Mean EQ-5D-5 L score was 83.8 (72-82). Average time to union was 9 months (6-12 months). Four (17.4%) cases needed autologous bone graft. Conclusions: Double incision dual-plating approach for distal femoral fractures is effective and provides stable construct without reduction loss allowing early rehabilitation. Single lateral plating of distal femur fractures was associated with relatively higher failure rate. Addition of medial plate along with lateral plate reduces chances of fixation failure.