The study on functional outcomes of dual plating in comminuted distal femur fractures
Keywords:
AO/OTA 33-C2/33-C3, Locking plate fixation, Comminuted fracture, Distal femur fracture, Dual plating, Early mobilization, Functional outcome, Medial column support, Neer’s knee score, Radiological unionAbstract
Background: Comminuted intra-articular distal femur fractures (AO/OTA 33-C2/C3) are difficult to manage due to medial column deficiency and the high risk of failure with single lateral plating. Dual plating has been proposed to improve stability and allow early mobilisation. Methods: A prospective observational study was conducted at BIRRD Hospital, Tirupati, from January 2022 to November 2024. Thirty-five adults with AO/OTA 33-C2/C3 fractures treated with dual plating were followed for at least 12 months. Demographics, fracture type, time to union, knee range of motion, Neer’s score, weight-bearing milestones, and complications were recorded. Results: The mean age was 42.6 years; 74.3% of injuries were due to road traffic accidents. Fracture distribution was 33-C2 in 42.9% and 33-C3 in 57.1%. Mean time to radiological union was 16.8 weeks, with 91.4% uniting without re-surgery. Neer’s score at one year showed 45.7% excellent and 37.1% good outcomes (82.8% excellent–good). Mean knee flexion was 112°, and 82.9% achieved ≥90° flexion. Complications included delayed union (8.6%), superficial infection (2.9%), stiffness (5.7%), and implant failure (2.9%), with no non-unions. Conclusion: Dual plating provides stable fixation, high union rates, good functional outcomes, and low complication rates in comminuted distal femur fractures. Further comparative studies are warranted.
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References
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