Observational studyJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology2025
Double plating versus nail-plate construct in AO 33C distal femur fractures: treatment choice affects knee alignment, clinical outcomes, and quality of life-a multicenter study.
Observational study in Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Nail-Plate Combination Fixation for Periprosthetic Distal Femoral Fractures Allows Early Weight-Bearing With Low Reoperation and Revision Rates.The Journal of arthroplasty · 2026Article
- Outcomes of Periprosthetic Distal Femur Fractures by Fixation Construct: A Retrospective Cohort Study.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Revision Surgery After Failed Fixation of Periprosthetic Distal Femur Fractures: Nail-Plate Combination Versus Double Plating.Medicina (Kaunas, Lithuania) · 2026Article
- [Value of retrograde femoral nailing : Pros and cons].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- Article
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Authors and funding
15 authors.
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Abstract
backgroundDistal femur fractures present a significant challenge for orthopedic surgeons, accounting for approximately 5% of all femoral fractures. Among the most commonly reported combined techniques in the literature are the double-plate technique and the retrograde nailing plus lateral plating, the nail-plate construct (NPC). The aim of our study is to compare surgical data, quality of life, and functional outcomes in 33-C fractures treated with either double-plate constructs or a retrograde nailing plus lateral plate. MATERIALS AND
methodsA multicenter retrospective observational study was conducted in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Diagnoses were made on the basis of the AO classification, utilizing traditional radiological assessments. Patients were categorized into two groups on the basis of the surgical treatment they received: The NPC group comprised patients who underwent surgery with nail-plate construct, while the Plate group consisted of those who had surgery with double plating.
resultsA total of 42 patients were included in the study. The NPC group comprised 26 patients with a mean age of 58.4 ± 18.8 years, while the Plate group consisted of 16 patients with a mean age of 61.3 ± 16.4 years. Significant differences were observed in knee extension recovery (p = 0.010) and lateral distal femur angle (LDFA) (p < 0.001). Linear regression showed a significant influence from treatment choice on all the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, as well as in all domains of the European Quality of Life Five Dimensions Five-Level Version (EQ-5D-5L), except for the Daily Self-Care domain.
conclusionsNail-plate constructs seems to lead to significantly better outcomes in AO type C distal femur fractures, compared with double plating, in terms of knee function and quality of life. Significant differences are shown also in anatomical outcomes, especially in extension gap, and LDFA. LEVEL OF EVIDENCE: III.
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