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Failure of dual plating in a complex open distal femur fracture as the result of major trauma
  1. Thomas Robert William Ward,
  2. Kanai Garala and
  3. Bryan Riemer
  1. Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  1. Correspondence to Thomas Robert William Ward; thomasrwward{at}


A 61-year-old polytrauma patient was admitted with a right distal comminuted metaphyseal femoral fracture with intra-articular extension (Orthopaedic Trauma Association 33C2.3 classification) among other injuries. Due to the high degree of comminution and massive bone loss, this was initially managed with a dual plating open reduction internal fixation. Dual plating has shown to be a superior fixation method than single variable angle locking compression plate (VA-LCP) plating providing greater fixation in metaphyseal bone. Our case reports the failure of dual plating which required removal of metalwork and subsequent fixation using intramedullary nail and plate technique. Failure of dual plating is not well documented in the literature. The most recent radiographs taken 15 months postrevision surgery show that the bone has started to heal with evidence of callus formation.

  • trauma
  • orthopaedics

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  • Contributors Authors in order: TRWW, KG and BR. TRWW: Planning, consenting patient, write up of report, and submission. KG: Idea for conception of case report, collected information regarding history of events, assisted in write up. BR: Conception of case report, lead operating consultant, reviewed patient follow up in clinic, assisted in write up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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