Dual Plating for Periprosthetic Distal Femoral Fractures Using the Extensile Medial or Lateral Parapatellar Approach

Periprosthetic distal femoral fractures (PDFFs) are increasing in incidence, typically affecting frail elderly patients who have complex needs. Although the use of distal femoral endoprostheses in the management of these fractures is increasing exponentially, concerns about their longevity and mechanical failures in younger patients should limit their use to older patients with limited life expectancies. In this study, we report the surgical technique for dual plating PDFFs using an extensile medial or lateral parapatellar approach and illustrate this technique with case examples. We describe the results of a case series of 15 patients who underwent dual plating for acute PDFF from 2015 to 2021 (87% female, median age 78 years; interquartile range 73-88) at a median follow-up duration of 2.4 years (interquartile range 2.0-4.2).