A comparative analysis of single lateral plate versus double plating for the fixation of distal femoral fractures: a randomized clinical trial

Background: Dual plating may enhance stability for comminuted distal femur fractures, but its comparative efficacy versus single lateral plating remains unclear. Materials and Methods: In this randomized trial, 32 patients with distal femoral fractures (AO A1–C3) were allocated to single lateral plating (Group I, n=16) or double plating (Group II, n=16). Outcomes, including union time, range of motion (ROM), Knee Society Score (KSS), and complications, were assessed over a mean follow-up of 42.80±6.84 weeks. Results: Time to radiologic union was identical (13.25 wk). Group I had a significantly greater mean ROM (105.31±14.77 degrees) than Group II (93.37±16.62 degrees; P =0.040). The double-plate group had a higher proportion of “excellent” KSS grades (43.8% vs. 6.3%, P =0.044). Intraoperative blood loss was higher in Group II (856.25±191.37 mL vs. 684.38±155.69 mL, P =0.009). Stability, alignment, and complication rates were comparable. Conclusion: While double plating may yield superior functional grades, single plating offers better ROM and less blood loss. Both techniques provide comparable stability and healing. The choice should be individualized based on the fractured pattern and patient factors.