{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:18Z","timestamp":1788182478599,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The incidence of distal femur fractures has a bimodal age distribution, predominantly occurs in females, and increases with advancing age. A third of these fractures occurred as periprosthetic fractures. Most are caused by trivial trauma, suggesting an increase in incidence with decreased bone quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and the Cochrane Library databases were searched using search terms: \u201cfemur fracture,\u201d \u201cdistal femur fracture,\u201d \u201cdual plate,\u201d \u201cmedial plate,\u201d and \u201cdouble plate.\u201d Articles published in English, up to and including November 2024 were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Nine studies, one randomized controlled trial and eight retrospective studies, were selected. Statistical analysis was performed using RevMan software. Continuous variables were analyzed using weighted mean difference, whereas dichotomous variables were analyzed using relative risk. The dual-plate group is significantly superior in terms of union rate, time to union, and revision surgery rates. There is no significant difference in the rate of infection, implant failure, and functional outcome, such as knee severity score and knee range of motion, and a significant increase in operative time and intraoperative blood loss in dual plating when compared to single plating for fracture of the distal femur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The improved stability and reduced rates of delayed union, malunion, and nonunion make dual plating a preferable option for comminuted distal femur fractures despite increased blood loss and operative time, as the outcome outweighs the associated risks.<\/jats:p>\n                  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