{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:10:13Z","timestamp":1756368613476,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,22]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Distal femoral fractures (DFFs) are frequently characterised by significant comminution, osteoporosis, high implant failure, insufficient fixation because of a shortened distal part, non-union, malunion, and poor outcome. Our report presents two cases treated with dual plating in a 90\u201390 construct to achieve torsional stability. DFF fixation by dual plating in a 90\u201390 configuration proved to be a superior fixation similar to 90\u201390 plating for distal humerus fracture, since 90\u201390 plate fixation had significantly greater torque to failure load and has more resistance to torsional loading. Two cases of distal femur non-union with implant failure were treated utilising a double plating. These non-union cases exhibited radiological healing and knee range of motion at a mean follow-up of 6 months. This technique offers a modified way of treating these difficult non-union cases through a single incision, providing mechanical stability conducive to fracture healing.<\/jats:p>","DOI":"10.1136\/bcr-2023-258919","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T23:00:15Z","timestamp":1728428415000},"page":"e258919","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Achieving torsional stability of distal femur fractures through a single approach using 90\u201390 construct"],"prefix":"10.1136","volume":"17","author":[{"given":"Sanjay R","family":"Agarwala","sequence":"first","affiliation":[{"name":"Orthopedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayank","family":"Vijayvargiya","sequence":"additional","affiliation":[{"name":"Orthopedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinashdev Devmani","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Orthopaedics, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"2025082800551509000_17.10.e258919.1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s00590-017-2014-9","article-title":"Double plating of intra-articular multifragmentary C3-type distal femoral fractures through the anterior approach","volume":"28","author":"Imam","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"2025082800551509000_17.10.e258919.2","doi-asserted-by":"crossref","first-page":"2260","DOI":"10.1016\/j.injury.2017.07.025","article-title":"A double-plating approach to distal femur fracture: a clinical study","volume":"48","author":"Steinberg","year":"2017","journal-title":"Injury"},{"key":"2025082800551509000_17.10.e258919.3","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1016\/j.arth.2014.01.025","article-title":"Modern retrograde intramedullary nails versus periarticular locked plates for supracondylar femur fractures after total knee arthroplasty","volume":"29","author":"Meneghini","year":"2014","journal-title":"J Arthroplasty"},{"doi-asserted-by":"publisher","key":"2025082800551509000_17.10.e258919.4","DOI":"10.1007\/s11999-010-1530-2"},{"unstructured":"Wang A , Zong S , Su L , et al . Meta-analysis of postoperative complications in distal femoral fractures: retrograde intramedullary nailing versus plating. 2016. 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