Work

Clinical and radiological outcomes of double plating in periprosthetic distal femur fractures after total knee arthroplasty

Year: 2026

Type: article

Abstract: Aim Periprosthetic distal femur fractures (PDFF) are challenging injuries, particularly in elderly patients with osteoporotic bone. Double plating has emerged as a fixation strategy; however, its clinical value remains incompletely defined. This study aimed to describe the surgical technique and evaluate the clinical outcomes of double plating in PDFF. Methods Twelve consecutive patients treated with double plating for PDFF between 2021 and 2025 were retrospectively reviewed. Demographic data, arbeitsgemeinschaft für osteosynthesefragen (AO) and Su classifications, type of secondary plate, follow-up duration, union status, and revision requirements were analyzed. All patients were female, with a mean age of 80.3 years (63–91). According to AO classification, six fractures were 33A2 and six were 33A3. Based on Su’s classification, two were Type 1 and ten were Type 2. A lateral distal femur anatomical locking plate was used in all cases, combined with various medial or supplementary plates. The mean follow-up was 10.9 months (3–17). Results Union was achieved in 11 patients without additional surgery. One patient developed nonunion with implant failure and underwent revision osteosynthesis, achieving union at final follow-up. Overall, fracture healing was achieved in all patients. One patient required outpatient debridement and oral antibiotics for wound complications. All patients regained independent mobilization postoperatively. Conclusion In elderly patients with osteoporotic bone, single-plate fixation may be insufficient for PDFF. Double plating provided stable fixation, high union rates, and acceptable complication rates, representing a reliable treatment option with appropriate patient selection and surgical technique.

Source: The Annals of Clinical and Analytical Medicine

DOI: 10.4328/acam.23049

Authors: Numan Mercan, Ahmed Faruk Çamcı, Cemil Emre Gökdemir, Volkan Taşdemir, Ahmet Yurteri

Institutions: Kahramanmaraş Sütçü İmam University, Konya City Hospital

Language: English

Topic: Bone fractures and treatments

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7219716488