Type C3 Fractures of Distal Femur Lateral Plating vs. Double Plating a Systematic Review and Meta-Analysis

Background Distal femur fractures account for about 30% of all femur fractures. Managing complex AO type C3 distal femoral fractures remains a significant challenge in orthopedic surgery. Complex distal femur fractures are characterized by articular comminution, metaphyseal involvement, and frequently compromised medial column support. Surgical management goals include anatomical articular reduction, rigid and stable internal fixation, and early range of motion. Although lateral locked plating has become a standard treatment option, reported failure rates ranging from 13-20% have raised concerns about the adequacy of single-plate fixation in complex fracture types. Objective To review the outcomes of the use of lateral plating and double plating in fixation of type C3 supra condylar fracture of femur. Patients and Methods We included both retrospective and prospective studies to provide a comprehensive assessment of current evidence regarding both fixation strategies. Results Our findings suggest that double plating is not associated with a significantly greater blood loss, despite the additional surgical exposure required. The mean blood loss was higher in the double plating but not significantly different compared to single plating (397.55 mL vs. 377.87 mL; difference, 19.68 mL; P = 0.86). The pooled mean blood loss across all procedures was 389.96 mL. Conclusion Fixation of distal femur type C3 fractures by double plating technique is recommended in comparison to lateral plating technique.