Double plating via anterolateral and posterolateral approach for distal femoral fracture

Yasuaki Yamakawa; Yasutaka Masada; Ryuichiro Okuda; Toshiyuki Matsumoto; Takenori Uehara; Masanori Yorimitsu; Tomoyuki Noda; Toshifumi Ozaki

doi:10.1016/j.tcr.2023.100803

Double plating via anterolateral and posterolateral approach for distal femoral fracture

Trauma Case Rep. 2023 Feb 18:44:100803. doi: 10.1016/j.tcr.2023.100803. eCollection 2023 Apr.

Authors

Yasuaki Yamakawa^{1

2}, Yasutaka Masada¹, Ryuichiro Okuda¹, Toshiyuki Matsumoto¹, Takenori Uehara², Masanori Yorimitsu², Tomoyuki Noda^{3

4}, Toshifumi Ozaki²

Affiliations

¹ Department of Orthopedic Surgery, Kochi Health Sciences Center, Kochi, Japan.
² Department of Orthopedic Surgery, Okayama University Hospital, Okayama, Japan.
³ Department of Orthopedic Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan.
⁴ Department of Orthopedic Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan.

Abstract

Although there are some reports highlighting the applicability of double plates in distal femoral fractures, there is no standard approach or fixation method for supracondylar fractures combined with posterior coronal shear fractures. We report a case of distal femoral fracture treated with a lateral locking plate and posterior buttress plate using anterolateral and posterolateral approaches from one incision. A 70-year-old man was hit by a motorcycle and had an intra-articular distal femoral fracture involving a long medial proximal spike and a single lateral condyle fragment, with the lateral condyle fragment posteriorly displaced. A 12-cm lateral skin incision was made, and the joint was developed using a para-patellar approach from the anterior to iliotibial band. Posterior buttress plate fixation was successfully performed from behind the iliotibial band using a posterolateral approach, followed by cannulated cancellous screw and lateral locking plate fixation from the anterolateral window. Combined anterolateral and posterolateral approaches from one incision enable intra-articular exposure and fixation based on fixation principles for lateral condyle fragments combined with supracondylar fracture.

Keywords: Combined approach; Distal femoral fracture; Double plate; Hoffa fracture.

Publication types

Case Reports