Immediate full weight-bearing, reduced perioperative morbidity and mortality after surgery in the treatment of distal femur fractures using a standard lateral plate plus a helical moulded medial plate ostheosynthesis.

Purpose: To describe our clinical and functional experience in treating distal femur fractures using double helical plating with immediate full weight-bearing.

Method: A retrospective, unicentric, case series study, based on data from patients with distal femur fractures who underwent surgery between 1 November 2019 and 31 January 2024. All patients who had a distal femur fracture and fulfil the criterion of previous ambulation were surgically treated using a standard lateral plate plus a helical moulded medial plate osteosynthesis through a MIPO technique with immediate full weight-bearing. We assessed length of surgery, blood loss during surgery, ambulation at 48 h after surgery; and at 6 months: clinical ('excellent' ambulation) and functional success (motion and malalignment), mortality and radiological outcome. A descriptive analysis was performed.

Results: Seventy-three patients were diagnosed with distal femur fracture, of which 68 (7 men, 61 women, with a median age of 84 (range, 50-99) years old) were included in the study. Median length of surgery was 132 (range, 69-235) min, median blood loss during surgery was - 2.2 (range, 0.2-5) g/dL. At 4 days, all (100%) patients ambulated. At 6 months, clinical and functional success were 59.68% (95% CI 47.3-71.0%) and 98.38% (95% CI 91.4-99.7%), respectively; 6 (8.8%, 95% CI 4.1-17.9%) patients died, all the remaining had an excellent/good radiological assessment.

Conclusion: Double helical plating for treating distal femur fractures is a stable and minimally invasive osteosynthesis technique, which enables immediately full weight-bearing with a minimum risk of secondary displacement or fixation failure. This technique could be considered as a good option for the fixation of distal femur fractures in frail patients.