Functional Outcome of Dual Plating in Patients with Distal Femur Fracture: A Prospective and Retrospective Study

Background: Distal femur fractures, particularly AO/OTA Types C2 and C3, represent a significant surgical challenge due to complex comminution, proximity to the knee joint, and the biomechanical demands of weight-bearing. Single lateral plate fixation frequently fails to provide adequate medial column support, resulting in varus collapse and nonunion. Dual plating, employing both lateral and medial constructs, has emerged as a superior fixation strategy for these unstable fractures.

Objective: To evaluate the functional and radiological outcomes of dual plating in patients with complex distal femur fractures.

Methods: A combined prospective and retrospective study was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, involving 41 patients with complex distal femur fractures (AO/OTA Types C1, C2, C3) who underwent dual plating over a one-year study period with six-month follow-up. Outcome measures included fracture union rate, postoperative knee range of motion (ROM), functional outcome, and complication rate.

Results: AO Type 33-C2 was the most prevalent fracture pattern (46.3%), followed by C3 (34.1%) and C1 (19.5%). A 100% radiological union rate was achieved with a mean time to union of 9.66 ± 1.30 months. At six weeks, 48.8% of patients achieved 0–90° knee ROM. Good functional outcomes were observed in all 41 patients (100%), with an overall good clinical result in 92.7%. The complication rate was 4.9%.

Conclusion: Dual plating provides superior biomechanical stability, facilitates early mobilization, and yields excellent functional outcomes with minimal complications in complex distal femur fractures. It is a reliable fixation strategy, especially in osteoporotic and highly comminuted fractures.