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. 2024 Jan 1;38(1):36-41.
doi: 10.1097/BOT.0000000000002695.

Dual Plate Fixation of Periprosthetic Distal Femur Fractures

Nicholas A Andring  1 , Shannon M Kaupp, Kaitlin A Henry, Kathryn C Helmig, Sharon Babcock, Jason J Halvorson, Holly T Pilson, Eben A Carroll
Affiliations

Dual Plate Fixation of Periprosthetic Distal Femur Fractures

Nicholas A Andring et al. J Orthop Trauma. .

Abstract

Objectives: Dual implants for distal femur periprosthetic fractures is a growing area of interest for these challenging fractures with dual plating (DP) emerging as a viable construct for these injuries. In the current study, an experience with DP constructs is described.

Design: Retrospective case series with comparison group.

Setting: Level 1 academic trauma center.

Patient selection criteria: Adults >50 years old sustaining comminuted OTA/AO 33-A2 or 33-A3 DFPF treated with either DP or a single distal femur locking plating (DFLP). Patients with simple 33-A1 fractures were excluded. Prior to 2018, patients underwent DFLP after which the treatment of choice became DP.

Outcome measures and comparisons: Reoperation rate, alignment, and complications.

Results: 34 patients treated with DFLP and 38 with DP met inclusion and follow up criteria. Average follow up was 18.2 ± 13.8 months in the DFLP group and 19.8 ± 16.1 months in the DP group ( P = 0.339). The average patient age in the DFLP group was 74.8 ± 7.3 years compared to 75.9 ± 11.3 years in the DP group. There were no statistical differences in demographics, fracture morphology, loss of reduction, or reoperation for any cause ( P >.05). DP patients were more likely to be weight bearing in the twelve-week postoperative period ( P <0.001) and return to their baseline ambulatory status ( P = 0.004) compared to DFLP patients.

Conclusions: Dual plating of distal femoral periprosthetic fractures maintained coronal alignment with a low reoperation rate even with immediate weight bearing and these patients regained baseline level of ambulation more reliably as compared to patients treated with a single distal femoral locking plate.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

E. A. Carroll is a paid consultant for DePuy Synthes, recieves royalties from Globus, is a speaker for the AO Foundation, and recieves research support from both Depuy Synthes and the AO Foundation. The remaining authors report no conflict of interest.

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