Clinical Efficacy of Medial and Lateral Plating in Distal Femur Fractures: Thesis Study

Abstract

Abstract Background The problem of treating distal femoral fractures is complicated. The principles of the surgical management of supracondylar femur fractures have changed. Up until 1970, conservative management of these fractures was the recommended course of care. This was mostly caused by a lack of adequate implants and procedures. In modern times, locking compression plates offer the benefits of locking head screws, offering better fixation and absolute stability. This is significant in the treatment of fractures in osteoporotic bone because it enables the use of monocortical screws in the diaphyseal region, preserving the periosteum's blood supply and preventing structural bone loss to the opposite cortex. Varus collapse was the main complication, especially in osteoporotic bone. Therefore, anatomical reduction and rigid, stable fixation provided by double plating was considered the best option for treating this type of fracture. Patients and Methods This is a retrospective cohort study done in El Demerdash Hospital, Ain Shams University specialised hospitals, Air Force specialised hospital, and El Helmia military hospital through 20 cases of distal femur fractures of types 33-A3 to 33-C3, all of which were managed by dual plating and followed up for 6 months. People with open fractures, fracture type 33-A1, periprosthetic, and pathological fractures were excluded. Results In our study, through 20 cases with distal femur fractures between types 33-A3 and 33-C3, all managed by double plating, the mean age was 51.50, 6 of our patients had comorbidities (DM, HTN, or Both), the rest were medically free, the average operation time was 150 minutes, 2 of our patients needed a bone graft, the range of full union was from 3 to 6 months, the average AKSS among the 20 patients was 81.05, 14 of our cases achieved uneventful union, 2 cases had superficial wound infection, and 1 case had implant failure (screw cut out) and needed revision, so double plating is one of the better options to achieve bony union and a better functional outcome in severely comminuted distal femur fractures Conclusion Even though there were problems such as a lengthy operation and longer recovery period in our study, double plating is one of the best options for achieving bone union and a better functional outcome in severely comminuted distal femur fractures. Functional outcomes were excellent in 75% of cases and fair in 25% of cases, and the union rate was 100% with no Varus deformity or malunion.