Dual Plating versus Single Plating for Fracture of Distal Femur: A Meta-analysis of Comparative Studies.
Abhishek Guria, Kumar Vaibhav, Nihar Topno et al.
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In 30 seconds
This meta-analysis compared dual with single plating for distal femur fractures, drawing on nine studies: one randomised controlled trial and eight retrospective studies. Dual plating was associated with significantly higher union rates, shorter time to union and fewer revision surgeries. Infection, implant failure and functional outcomes did not differ significantly between approaches, while dual plating involved significantly longer operative time and greater intraoperative blood loss. The authors considered dual plating preferable for comminuted fractures, weighing these benefits against the additional operative burden.
Key findings
- Across nine studies, dual plating was associated with higher union rates, shorter time to union and fewer revision surgeries.
- Infection, implant failure and functional outcomes, including knee severity score and range of motion, did not differ significantly.
- Dual plating was associated with significantly longer operative time and greater intraoperative blood loss.
Why it matters
Distal femur fracture fixation involves balancing construct stability and healing against operative burden. This synthesis suggests dual plating may improve union-related outcomes and reduce revision surgery, without a demonstrated functional advantage or difference in infection and implant failure. These trade-offs are relevant when considering fixation options, particularly for comminuted fractures, while the evidence base includes mostly retrospective studies.
What to keep in mind
The meta-analysis included only nine studies, eight of which were retrospective; the abstract provides no pooled effect estimates or confidence intervals.