Double plating of intra-articular multifragmentary C3-type distal femoral fractures through the anterior approach

Mohamed A Imam, Ahmed Torieh, Ahmed Matthana

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


INTRODUCTION: In this prospective case series, we report a mean of 12-month follow-up of the utilization of a dual plating of distal femoral fractures. Our technique included a lateral distal femoral locked plate with a low-contact-locked medial plate and bone graft through an extended medial parapatellar anterior approach for the fixation of C3-type distal femoral fractures.

PATIENTS AND METHODS: Sixteen patients (11 males and 5 females) presented with supracondylar femoral fracture type C3, according to Müller long-bone classification system and its revision OA/OTA classification. These were treated using dual plating through extended anterior approach and bone grafting. Our outcomes included clinical and radiological outcomes. Secondary outcomes included postoperative complications.

RESULTS: The mean time of complete radiological union in the studied population was 6.0 ± 3.5 months with a range of 3-14 months. We have not observed postoperative varus or valgus deformity in our cohort. The majority (68.75%) of the studied patients showed significant improvement in range of motion (90°-120°) during follow-up. Eleven out of sixteen patients (68.75%) had well-to-excellent functional outcome. Poor outcome was reported in only two patients (12.50%).

CONCLUSIONS: Dual plating fixation using anterior approach for type C3 distal femoral fractures is an efficient method of management. It has several advantages such as precise exposure, easy manipulation, anatomical reduction and stable fixation. However, operative indications and instructions should be strictly followed. The surgical technique must be rigorous, and the biomechanical qualities of these implants must be understood to prevent the development of major complications.

Original languageEnglish
Pages (from-to)121-130
Number of pages10
JournalEuropean Journal of Orthopaedic Surgery & Traumatology
Issue number1
Early online date14 Jul 2017
Publication statusPublished - Jan 2018
Externally publishedYes


  • Adolescent
  • Adult
  • Bone Plates
  • Bone Transplantation
  • Female
  • Femoral Fractures/diagnostic imaging
  • Follow-Up Studies
  • Fracture Fixation, Internal/instrumentation
  • Fracture Healing
  • Fractures, Comminuted/surgery
  • Humans
  • Imaging, Three-Dimensional
  • Knee Joint/physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Range of Motion, Articular
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

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