Distal Femur Fractures - Technical Tips: Double Plate Fixation

Description

This lecture by David Helfet, presented from New York, covers the intricacies of double plate fixation in the treatment of distal femur fractures. Helfet explains that these fractures typically result from high-energy mechanisms in younger patients and low-energy injuries in older populations, where poor bone quality exacerbates vulnerabilities. He highlights the limitations of current treatment strategies, noting the notable rates of malunion and nonunion—up to 20%—even among cases managed by experienced trauma surgeons.



Helfet discusses the advantages of medial plating alongside lateral locked plating, which can mitigate excessive varus forces and create a more stable construct. He shares findings from a cadaver study showing that medial plating has a negligible effect on vascularity compared to lateral plating alone, thus supporting the rationale for its use.



Through various case studies, Helfet illustrates the surgical strategies employed for complex fractures, emphasizing the importance of dual plating, especially in periprosthetic cases and those involving significant comminution. He concludes by affirming the efficacy of double plate fixation in promoting healing in challenging fracture scenarios, particularly in the elderly, and advocates for this approach amid rising incidences of osteoporotic and interprosthetic fractures.

DOI: 10.1302/3114-221321

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