{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:55:15Z","timestamp":1784919315154,"version":"3.55.0"},"reference-count":82,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Locked plating for distal femur fractures is widely recommended and used. We systematically reviewed clinical studies assessing the benefits and harms of fracture fixation with locked plates in AO\/OTA Type 32 and 33 femur fractures. Methods: A comprehensive literature search of PubMed, Embase, Cinahl, Web of Science, and the Cochrane Database was performed. The studies included randomized and non-randomized clinical trials, observational studies, and case series involving patients with distal femur fractures. Studies of other fracture patterns, studies conducted on children, pathological fractures, cadaveric studies, animal models, and those with non-clinical study designs were excluded. Results: 53 studies with 1788 patients were found to satisfy the inclusion and exclusion criteria. The most common harms were nonunion (14.8%), malunion (13%), fixation failure (5.3%), infection (3.7%), and symptomatic implant (3.1%). Time to full weight-bearing ranged from 5 to 24 weeks, averaging 12.3 weeks. The average duration of follow-up was 18.18 months, ranging from 0.5 to 108 months. Surgical time ranged between 40 and 540 min, with an average of 141 min. The length of stay in days was 12.7, ranging from 1 to 61. The average plate length was ten holes, ranging from 5 to 20 holes. Conclusion: This review aimed to systematically synthesize the available evidence on the risk associated with locked plating osteosynthesis in distal femur fractures. Nonunion is the most common harm and is the primary cause of reoperation. The overall combined risk of a major and critical complication (i.e., requiring reoperation) is approximately 20%.<\/jats:p>","DOI":"10.3390\/jcm13051492","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T05:31:19Z","timestamp":1709616679000},"page":"1492","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Severity of Complications after Locking Plate Osteosynthesis in Distal Femur Fractures"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6669-5517","authenticated-orcid":false,"given":"Roshan","family":"Gurung","sequence":"first","affiliation":[{"name":"School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane City, QLD 4000, Australia"},{"name":"Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Terrill","sequence":"additional","affiliation":[{"name":"School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane City, QLD 4000, Australia"},{"name":"Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"},{"name":"School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gentry","family":"White","sequence":"additional","affiliation":[{"name":"School of Mathematical Sciences, Queensland University of Technology, Brisbane City, QLD 4000, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8077-6914","authenticated-orcid":false,"given":"Markus","family":"Windolf","sequence":"additional","affiliation":[{"name":"AO Research Institute Davos, 7270 Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7776-0962","authenticated-orcid":false,"given":"Ladina","family":"Hofmann-Fliri","sequence":"additional","affiliation":[{"name":"AO Innovation Translation Center, AO Foundation, 7270 Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Dlaska","sequence":"additional","affiliation":[{"name":"The Orthopaedic Research Institute of Queensland, Townsville, QLD 4812, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schuetz","sequence":"additional","affiliation":[{"name":"School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane City, QLD 4000, Australia"},{"name":"Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"},{"name":"Jamieson Trauma Institute, Metro North Hospital and Health Services, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9306-709X","authenticated-orcid":false,"given":"Devakara R.","family":"Epari","sequence":"additional","affiliation":[{"name":"School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane City, QLD 4000, Australia"},{"name":"Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1302\/0301-620X.78B1.0780110","article-title":"Displaced Fractures of the Distal Femur in Elderly Patients: Operative versus Non-Operative Treatment","volume":"78","author":"Butt","year":"1996","journal-title":"J. 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