Single vs. dual plating for distal femur periprosthetic fractures post-total knee arthroplasty: A comparative analysis of functional and radiographic outcomes

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2026-01-01 Epub Date: 2025-12-10 DOI:10.1016/j.jcot.2025.103308

Abhijit Das, Babaji Sitaram Thorat, Avtar Singh Kamboj, Arcot Reddy Vamsi Krishna, Kshitij Srivastav, Arshid H. Wani

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引用次数: 0

Abstract

Background

Periprosthetic distal femur fractures following total knee arthroplasty (TKA) are increasingly encountered and present considerable reconstructive challenges, with internal fixation remaining the mainstay of management. This retrospective comparative study examines the clinical and radiological outcomes of single locked plating versus dual plating in Rorabeck type I and II fractures.

Methods

A total of 45 patients treated between August 2017 and August 2024 were included (31 single plating; 14 dual plating). Functional outcome (Oxford Knee Score), union characteristics, weight-bearing timelines, and complications were compared.

Results

The study included 45 patients (30 females, 15 males), with a mean age of 67 ± 8.7 years. All fractures achieved union (100 % union rate) with a mean time to union of 4.4 ± 1.2 months. Dual plating achieved earlier fracture union (3.71 ± 1.35 months) and permitted earlier full weight-bearing (3.18 ± 1.22 months) compared with single plating (4.77 ± 0.85 months and 4.18 ± 0.84 months, respectively). Dual plating yielded significantly better functional outcomes than single plating, with progressively higher Oxford Knee Scores at 1, 3, and 6 months of follow-up (p < 0.05). Complication rates were comparable between groups (superficial infection 3 cases; deep infection 1; delayed union 3; malunion 1).

Conclusion

Dual plating is better than single locked plating for such injuries, as it provides a stable construct, anatomical reduction, early fracture union, early mobilization, excellent outcomes, and minimal complications.

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单钢板与双钢板治疗全膝关节置换术后股骨远端假体周围骨折：功能和影像学结果的比较分析

背景：全膝关节置换术（TKA）后股骨远端假体周围骨折越来越多，并且呈现出相当大的重建挑战，内固定仍然是治疗的主要方法。本回顾性比较研究探讨了单锁定钢板与双锁定钢板治疗Rorabeck I型和II型骨折的临床和影像学结果。方法纳入2017年8月至2024年8月收治的45例患者，其中单次镀31例，双次镀14例。比较功能结局（牛津膝关节评分）、愈合特征、负重时间和并发症。结果纳入45例患者，其中女性30例，男性15例，平均年龄67±8.7岁。所有骨折均愈合（100%愈合），平均愈合时间为4.4±1.2个月。与单钢板（分别为4.77±0.85个月和4.18±0.84个月）相比，双钢板可实现更早的骨折愈合（3.71±1.35个月）和更早的完全负重（3.18±1.22个月）。双钢板比单钢板的功能效果明显更好，随访1、3和6个月时牛津膝关节评分逐渐升高（p < 0.05）。两组间并发症发生率具有可比性（浅表感染3例，深部感染1例，延迟愈合3例，畸形愈合1例）。结论双钢板比单钢板具有结构稳定、解剖复位、骨折早愈合、早活动、疗效好、并发症少等优点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.