Clinical and Functional Outcomes of Dual Plating in Distal Femoral Fractures: A Retrospective Cohort Study

Background: Distal femoral fractures pose significant challenges in achieving stable fixation, especially in comminuted and osteoporotic cases. While lateral locked plates are widely used, they are associated with a high risk of nonunion and varus collapse. Medial plating as an adjunct has been proposed to enhance mechanical stability. However, concerns regarding vascular compromise and long-term functional outcomes remain. Objective: This study evaluates the clinical, functional, and radiological outcomes of distal femoral fractures treated with dual plating. Patients and Methods: A retrospective cohort study was conducted on 20 patients with Orthopaedic Trauma Association Classification System (AO/OTA) type 33-A3 to 33-C3 distal femur fractures managed with dual plating at four specialized hospitals between January 2022 and January 2023. Patients were assessed based on radiological union time, knee range of motion (ROM), and functional outcomes using the Knee Society Score (KSS). Results: The mean radiological union time was 4.40 ± 0.99 months, and full weight-bearing was achieved at 4.63 ± 0.96 months. Seventy-five percent of patients (n = 15) had good to excellent functional outcomes (KSS: 75–95), while 25% (n = 5) had fair to poor outcomes (KSS: 45–65). The mean knee ROM was 98.00 ± 22.79°. Postoperative complications occurred in 30% of cases, with knee stiffness (15%), superficial wound infections (10%), and implant failure (5%). Conclusion: Dual plating in distal femoral fractures provides favorable functional outcomes and stable fixation, with an almost 100% union rate. However, postoperative complications and delayed healing impact recovery.