Dual Plate Fixation of Periprosthetic Distal Femur Fractures.

Abstract

Dual implants for distal femur periprosthetic fractures (DFPF) 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 we review our experience with DP constructs. Retrospective case series with comparison group. Level 1 academic trauma centerPatients/Participants: 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 at our institution became DP. 34 patients treated with DFLP and 38 with DP met inclusion and follow up criteria. 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. Dual plating or single DFLP. Reoperation rate, alignment, and complications. 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). There were no statistical differences in demographics, fracture morphology, loss of reduction, or reoperation for any cause (p>.05). However, 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. 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.