Outcome of Bicolumnar Plating versus Lateral Column Plating in Distal Femoral Fractures: A Randomized Controlled Trial

Abstract Background: Surgical intervention of distal femoral fractures found better outcomes in comparison to conservative management, despite many complications were encountered. The aim of this work was to estimate the effectiveness, internal fixation, and open reduction advantages and disadvantages of using double plating in comparison to lateral fixation in the distal femoral fracture management according to the knee society score. Materials and Methods: This prospective randomized clinical study was performed on 40 patients aged from 18 to 70 years old, both sexes, with distal femoral fractures type C. Patients were randomly allocated using computer-generated randomization tables into two equal groups: Group (A) treated by lateral distal femur locked plate and group (B) treated by double plating. Results: Partial, full weight bearing and occurrence of healing were significantly better in Group B than in Group A ( P < 0.001, 0.003, and < 0.002, respectively). Regarding complications (superficial wound infection, deep infection, medial plate infection, deep venous thrombosis, and failure revision), revision was significantly greater in Group A than Group B ( P = 0.006 and 0.044, respectively). Pain, alignment, anteroposterior stability, mediolateral stability, and knee society scoring grades were insignificantly different among both groups. Conclusions: Although both single lateral plating and double plating fixation utilizing a single approach for type C distal femoral fractures are safe and efficient management methods, double plating has several advantages, for example, easy manipulation, precise exposure, anatomical reduction, and stable fixation. The time of union is less with double plating.