![]() Bibliographic details of the selected studies were manually searched to retrieve more articles. If the abstract was inadequate to give detailed information, the full text was extracted. The abstract of the retrieved articles was assessed to look for possible inclusion in the study. The search was limited to the English language and human beings (Table (Table1). The following keywords were used in different combinations using Boolean operators: distal femur fracture, supracondylar femur fracture, single plating, lateral locking plate, dual plating, double plate, distal femur plating, and medial femoral plating. ![]() Electronic searches of the medical literature databases including PubMed, Medline, EMBASE, and Cochrane Central Register of Controlled Trials were done by three authors (SKT, PV, and NPM) on December 1, 2020. This study was registered in PROSPERO (CRD42021230418). The guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed to report this systematic review. Therefore, this systematic review was designed to evaluate the available literature on dual plating in distal femur fracture and compare the functional outcomes and complications with the single lateral locked plate. However, it is not recommended routinely for these fractures as the superiority to traditional lateral locked plating is not proven with regards to union rate, functional outcomes, and complications. Dual plating stabilizes both the columns of the distal femur and provides a stronger fixation in comminuted supracondylar femur fractures, low periprosthetic fracture and nonunions. Subsequently, multiple small cases series reported a satisfactory result. ![]() They reported union all their patients who had a complex intraarticular fracture (C2, C3). In addition to the lateral distal femoral plate, medial plating was first reported by Sander's et al. Other studies have also reported that there is a safe medial interval (up to about 16 cm proximal to the adductor tubercle) for plating with little danger to the femoral artery, nerve and their branches. It is evident that the majority of vascular insult secondary to open reduction and internal fixation of the distal femur occurs because of lateral locked plating and not from the addition of a medial plate. reported that there was a 21.2% total reduction in the distal femoral arterial contribution after fixation with a lateral locked plate via lateral sub-vastus approach however, a supplementary medial reconstruction plate (3.5 mm) fixation lead to a 25.4% total reduction in the vascularity. However, a recent study has abolished the concept of vascularity compromise with dual plating. The major concerns for medial plating are unfamiliar approach, proximity to the neurovascular bundle and belief among surgeons that it would compromise the medial vascularity. Augmentation of the lateral locked plate construct with a medial plate reduces the chances of failure. The metaphyseal comminution, poor bone quality, and inadequate fixation lead to varus collapse and nonunion. Although lateral locking plates can address these issues and are commonly used for such fractures, the nonunion rate can go up to 18–20%. Surgical fixation in these fractures aims to achieve anatomical articular reduction, preservation of the blood supply, and rigid internal fixation to start early mobilization. It has a bimodal age distribution with typical occurrence in the young individuals (around 20 years old, traffic or sport) and the older women (around 70 years old, fall at home, osteoporosis). Distal femoral fractures represent 3–6% of femoral fractures and 0.4% of all fractures.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |