Staged Bone Graft with Dual Plate Augmentation for AO Type-C3 Complex Distal Femur Fractures: Is It a Valid Option?

Abstract Background: Distal femur fractures accounts for about 8.7/1,00,000 population per year. 4-6% of femoral fractures, 1% of all fractures. The aim of this study is to analyze clinical and functional outcomes of type-C3 distal femur fractures managed with dual staged plating. Materials and Methods: Patients with arbeitsgemeinschaft für osteosynthesefragen type C3 distal femur fractures of age 18–70 yrs presented to our hospital between Jan 2018 and Dec 2022 who are surgically treated with minimum follow-up for 2 years ( n = 74). Post operatively patients were followed up using NEER’s and Lysholm knee score at 2 year follow-up. Result: Out of 74 cases of C3 fractures, male predominant (47:27), 42cases operated with staged dual plating (M:F = 31:11) ( n = 42). Being most common injuries 15-open fractures, 27-closed fractures. 42 cases operated with primary lateral plating, 40 cases operated with medial plate and bone graft augmentation 6 weeks later, 2 cases of superficial infection treated with cement beads application and medial plate+ bone graft as stage-3. Three case of superficial infection are treated with IV antibiotics. Six cases of knee stiffness after stage-1 treated with arthrolysis, manipulation at stage 2 and physio. LYSHOLM score = excellent -87%, good-10%, fair-3% for Dual plate at 2-year follow-up. Conclusion: Anatomical reduction and rigid fixation of intraarticular fractures, early ROM, aggressive physio are mandatory for optimum care. Our study showed that AO33C3 fractures are treated with staged Dual plating has better union rate, early weight bearing, better stability and good knee ROM.