Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study

Introduction: The treatment of distal femur fractures with metaphyseal comminution is often complicated by nonunion, varus collapse, and implant failure. The accepted standard of treatment is lateral plating with a distal femur-locking compression plate. The addition of an extra medial plate to the...

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Main Authors: Ebin Jose, V Singaravadivelu, D S Anandan, S S Sailesh, Cheralathan Senguttuvan
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-07-01
Series:Journal of Orthopedics and Joint Surgery
Subjects:
Online Access:https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1120
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author Ebin Jose
V Singaravadivelu
D S Anandan
S S Sailesh
Cheralathan Senguttuvan
author_facet Ebin Jose
V Singaravadivelu
D S Anandan
S S Sailesh
Cheralathan Senguttuvan
author_sort Ebin Jose
collection DOAJ
description Introduction: The treatment of distal femur fractures with metaphyseal comminution is often complicated by nonunion, varus collapse, and implant failure. The accepted standard of treatment is lateral plating with a distal femur-locking compression plate. The addition of an extra medial plate to the lateral plate provides more mechanical stability. We compared the radiological and functional outcome of these fractures following dual plating and lateral plating. Materials and methods: A total of 20 were selected and randomized and divided into two groups. The inclusion criteria were all distal femur fractures with metaphyseal comminution. Gustilo-Anderson type IIIB and type IIIC fractures were excluded from the study. Dual plating was done in the first group by two approaches, lateral and subvastus approach, while lateral plating was done in the second group by the lateral approach. Patients were followed up for 2 years. Radiological and functional outcomes were assessed on follow-up. Result: There was a statistically significant difference in average time for radiological union, which was 13 weeks in the dual plating group and 28 weeks in the lateral plating group (<i>p</i>-value = 0.038). Patients with dual plating had early weight bearing. There was no significant difference in functional outcome between both groups. Conclusion: Dual plating for distal femur fractures with metaphyseal comminution results in an early radiological union and early weight bearing and allows an early return to work.
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spelling doaj-art-a3417ecc266e4b5799008a69372cb6f52025-08-20T04:02:09ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632023-07-0152596510.5005/jojs-10079-11205Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control StudyEbin Jose0V Singaravadivelu1D S Anandan2S S Sailesh3Cheralathan Senguttuvan4https://orcid.org/0000-0003-2974-6845Institute of Orthopedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, India, Phone: +91 9562458122Institute of Orthopedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, IndiaInstitute of Orthopedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, IndiaInstitute of Orthopedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, IndiaInstitute of Orthopedics and Traumatology, Madras Medical College, Chennai, Tamil Nadu, IndiaIntroduction: The treatment of distal femur fractures with metaphyseal comminution is often complicated by nonunion, varus collapse, and implant failure. The accepted standard of treatment is lateral plating with a distal femur-locking compression plate. The addition of an extra medial plate to the lateral plate provides more mechanical stability. We compared the radiological and functional outcome of these fractures following dual plating and lateral plating. Materials and methods: A total of 20 were selected and randomized and divided into two groups. The inclusion criteria were all distal femur fractures with metaphyseal comminution. Gustilo-Anderson type IIIB and type IIIC fractures were excluded from the study. Dual plating was done in the first group by two approaches, lateral and subvastus approach, while lateral plating was done in the second group by the lateral approach. Patients were followed up for 2 years. Radiological and functional outcomes were assessed on follow-up. Result: There was a statistically significant difference in average time for radiological union, which was 13 weeks in the dual plating group and 28 weeks in the lateral plating group (<i>p</i>-value = 0.038). Patients with dual plating had early weight bearing. There was no significant difference in functional outcome between both groups. Conclusion: Dual plating for distal femur fractures with metaphyseal comminution results in an early radiological union and early weight bearing and allows an early return to work.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1120distal femur fracturedual platinglateral platingmetaphyseal comminutionvarus collapse
spellingShingle Ebin Jose
V Singaravadivelu
D S Anandan
S S Sailesh
Cheralathan Senguttuvan
Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
Journal of Orthopedics and Joint Surgery
distal femur fracture
dual plating
lateral plating
metaphyseal comminution
varus collapse
title Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
title_full Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
title_fullStr Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
title_full_unstemmed Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
title_short Does Dual Plating for Distal Femur Fractures with Metaphyseal Comminution Results in Increased Stability and Early Fracture Healing: A Prospective Randomized Control Study
title_sort does dual plating for distal femur fractures with metaphyseal comminution results in increased stability and early fracture healing a prospective randomized control study
topic distal femur fracture
dual plating
lateral plating
metaphyseal comminution
varus collapse
url https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1120
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