The Role of Adjunctive Medial Plating in Distal Femur Fractures and Distal Femur Fractures Nonunions

In the acute fracture setting, the dual-plate construct had a shorter time to union (22.1 weeks vs. 29.5 weeks, p=0.1337) and a better union rate (100% vs. 73.6%, p=0.1848), though neither were statistically significant. Complication rates between dual plating and single lateral plating were similar (20% dual plate vs. 14.3% single lateral plate, p=0.7245). For femoral nonunions, both treatment groups achieved a 100% union rate. The time to union was slightly longer in patients treated with an adjunctive medial plate (35 weeks vs. 31 weeks, p=0.6207). However, medial adjunctive plating had a lower complication rate (0% vs. 26.7%, p=0.1081). Conclusion: Dual plating plays a valuable role in the management of acute distal femur fractures, as well as in the adjunctive medial plating of distal femur nonunions treated with a lateral plate construct. This approach is especially beneficial for cases with inadequate medial cortical support or a high risk of varus collapse.