Outcome of dual implantation in distal end femur fractures among patients attending a tertiary care hospital in Karnataka

Background: Distal femur fractures, comprising 6% of femur fractures. These fractures demand precise surgical interventions, especially Muller’s Type C2 and C3 variants, necessitating stable fixation. Dual implants like double-plate and plate-and-nail constructs offer promising anatomical reconstruction. The study was done to estimate the effect of dual implantation in distal femur fracture on union and clinical outcomes of the patients. Methods: Study was done on 30 patients who underwent dual implantation surgery for distal femur fractures. We specifically focused on Muller's C2 and C3 types, and included cases of periprosthetic fracture or implant failure. Patient demographics, medical histories, fracture characteristics (laterality, type, knee status, injury mode, and associated injuries), and clinical outcomes after follow-up were extracted from records and through clinical observation. Analysis done through R-Software. Results: Study participants primarily aged above 60 years (30.0%), mostly males (53.3%), exhibited fractures over the right femur (63.3%). Muller’s Type C3 fractures were predominant (66.7%), often associated with comorbidities (60.0%) and risk factors (43.3%), mainly RTAs (53.35%). Plate-plate constructs were common (73.3%), with favorable outcomes in 83.3% showing complete healing and 66.7% normal working capacity. Complications occurred in 60.0%, mainly limb length discrepancy (43.3%), valgus deformity (36.7%), and infection (16.7%). There is no statistically significant difference in outcome between type of fractures and dual implants used. Conclusion: For distal femur fractures, particularly Muller's type-C2 and C3, Dual implants, such as dual plates or plate with nail, offer favorable clinical outcomes, acceptable knee motion, high union rates, and optimal supra patella area reconstruction, and thus can be recommended as a standard procedure for managing complex distal femur injuries.