Combined medial parapatellar and lateral approaches in management of type C III distal femur fractures “A prospective case series study”

BackgroundDistal femur fractures are becoming increasingly common, particularly among elderly patients. Double-plating fixation is a well-established surgical technique that provides enhanced biomechanical stability, especially in comminuted intra-articular and metaphyseal fractures, which are frequently encountered in osteoporotic bone.Aim of the WorkThis study aimed to evaluate the outcomes of combined medial parapatellar and lateral approaches in the management of Type CIII distal femur fractures, with particular emphasis on functional outcomes and postoperative complications.Patients and MethodsThis prospective case series included twelve patients with Type CIII distal femur fractures treated with double plating through combined medial parapatellar and lateral approaches. Clinical and radiological outcomes, as well as postoperative complications, were assessed. Open fractures, pediatric femoral fractures, fractures associated with pre-existing tumors, and periprosthetic fractures were excluded. The follow-up period was one year.ResultsThe mean time to complete fracture union was 5.0±1.0 months (range: 4–8 months). A significant improvement in knee range of motion was observed throughout the follow-up period, ranging from 90° to 120°. Functional outcomes were satisfactory: 50% of patients achieved excellent results, 33.3% good results, and 16.7% fair results according to the clinical scoring system described by Sanders et al.,.ConclusionsDouble-plating fixation using combined medial parapatellar and lateral approaches is an effective method for managing Type CIII distal femur fractures. This technique offers improved exposure of the articular surface, facilitates fracture manipulation, and provides rigid fixation, resulting in satisfactory functional outcomes.