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Highly unstable complex C3-type distal femur fracture: can ...
C3 Distal Femoral Fractures, which involve significant articular comminution (complex, multiplanar, and bicondylar), are effectively managed using locking plate systems. While single lateral locked plating is common, dual plating (lateral + medial) is often preferred for optimal stability in C3 fractures, especially with medial comminution or osteoporosis. 
Key Considerations for C3 Fractures: 
  • Fixation Method: Dual plating provides superior biomechanical stability with significantly lower stress and reduced motion at the fracture site compared to single plates.
  • Common Plate Systems: Locking compression plates (LCP) and specialized distal femur locking plate systems (e.g., from Double Medical or AO Foundation) are used.
  • Approach: A lateral approach, often combined with a modified swashbuckler approach, allows for exposure and reduction of the articular surface.
  • Outcomes: Studies show high union rates (average 14.3 weeks) and good range of motion (mean 121°) using these systems for severe C3 injuries.
  • Risks: Without stable, rigid fixation (specifically in osteoporotic patients), these fractures are prone to varus collapse, non-union, and malunion. 
For detailed surgical techniques, resources such as AO Surgery Reference are frequently used by surgeons to plan for these complex, high-energy fractures. 
  • Complex AO type C3 distal femur fractures: Results after fixation with a lateral locked plate using modified swashbuckler approach - PMC
    A medical expert, like a doctor, is best able to help you find the information and care you need. This information does not consti...
    National Institutes of Health (.gov)
  • Dual Plating of the Distal Femur: Indications and Surgical Techniques
    Dec 27, 2019 — In patients with distal femur fracture with osteoporotic bone, there is a high incidence of failure of fixation with a single late...
    National Institutes of Health (.gov)
  • Highly unstable complex C3-type distal femur fracture - PMC
    Müller et al. [3] classified these fractures according to their location and pattern. Their classification broadly divides distal ...
    National Institutes of Health (.gov)
  • Single-Incision Double-Plating Approach in the Management of ...
    Introduction: Distal femoral fractures in elderly population had recorded an increase in incidence in the last 2 decades. Lateral ...
    PubMed Central (PMC) (.gov)
  • Finite element analysis of 3 internal fixations for distal type C3 femur ...
    Nov 28, 2023 — The maximum relative displacements of implants during compressive loading were 1.34, 1.25, and 0.83 mm for the single-plate , retr...
    National Institutes of Health (.gov)
  • Femur, Distal - Intraarticular Fracture (33C2.1) - Fixation With ...
    Dec 2, 2021 — in this presentation. a 33C2.1 fracture will be treated with the LCP distal femur plate or DF. using the less invasive stabilizati...
    14:52
    YouTube·Pathognomonique
  • (PDF) AO Surgery Reference - Distal Femur and Patella
    Sep 30, 2019 — Also publishes an online interactive AO Surgery Reference which provides the classifications for bone fracture and recommends fixa...
    ResearchGate
  • Complex AO type C3 distal femur fractures: Results after fixation with a lateral locked plate using modified swashbuckler approach - PMC
    A medical expert, like a doctor, is best able to help you find the information and care you need. This information does not consti...
    National Institutes of Health (.gov)
  • Dual Plating of the Distal Femur: Indications and Surgical Techniques
    Dec 27, 2019 — In patients with distal femur fracture with osteoporotic bone, there is a high incidence of failure of fixation with a single late...
    National Institutes of Health (.gov)
  • Highly unstable complex C3-type distal femur fracture - PMC
    Müller et al. [3] classified these fractures according to their location and pattern. Their classification broadly divides distal ...
    National Institutes of Health (.gov)
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Web results

Distal Femur Fractures - Trauma


Orthobullets
https://www.orthobullets.com › trauma › distal-femur-fr...
Orthobullets
https://www.orthobullets.com › trauma › distal-femur-fr...
Apr 18, 2025 — Displaced distal femur fractures may result in injury to the popliteal artery. Treatment: Nonoperative: immobilization with hinged knee brace.Read more
C3 Distal Femoral Fracture Plate from www.orthobullets.com

Complex AO type C3 distal femur fractures - PMC


National Institutes of Health (.gov)
https://pmc.ncbi.nlm.nih.gov › articles › PMC5296844
National Institutes of Health (.gov)
https://pmc.ncbi.nlm.nih.gov › articles › PMC5296844
by A Agrawal · 2017 · Cited by 38 — Our study shows a good to excellent functional outcome of complex C3 type distal femur fractures, fixed with a single lateral locked plate, using a modified ...Read more

Distal femur - AO Surgery Reference


AO Foundation Surgery Reference
https://surgeryreference.aofoundation.org › adult-trauma
AO Foundation Surgery Reference
https://surgeryreference.aofoundation.org › adult-trauma
We help you diagnose your Distal femur case and provide detailed descriptions of how to manage this and hundreds of other pathologies.

Type C3 Fractures of Distal Femur Lateral Plating vs. Double ...


Oxford Academic
https://academic.oup.com › Supplement_1 › hcaf224.184
Oxford Academic
https://academic.oup.com › Supplement_1 › hcaf224.184
by AM El Badrawy · 2025 — Fixation of distal femur type C3 fractures by double plating technique is recommended in comparison to lateral plating technique. Distal Femur Lateral Plating, ...Read more

Double plating of intra-articular multifragmentary C3-type ...


Sociedad Española de la Rodilla
https://www.serod.org › pdf › Double_plating_of...
Sociedad Española de la Rodilla
https://www.serod.org › pdf › Double_plating_of...
PDF
by MA Imam · 2017 · Cited by 66 — In our study, sixteen patients with type C3 distal femoral fracture were treated using dual plating (medial and lateral) through extended anterior approach and ...Read more

[Treatment of type C3.3 distal femoral fractures with double ...


National Institutes of Health (.gov)
https://pubmed.ncbi.nlm.nih.gov › ...
National Institutes of Health (.gov)
https://pubmed.ncbi.nlm.nih.gov › ...
by D Lin · 2010 · Cited by 13 — Objective: To investigate the efficacy of double-plating fixation via U-shaped incision in the treatment of type C3.3 distal femoral fractures.Read more

C3 Distal Femoral Locking Plate System


Double Medical
https://www.doublemedicalgp.com › Plate
Double Medical
https://www.doublemedicalgp.com › Plate
C3 Distal Femoral Locking Plate System is developed for repairing the multi fractures of distal femur, nonunion, malunion. Inquiry now. Product Detail.Read more
C3 Distal Femoral Fracture Plate from www.doublemedicalgp.com

Distal Femur Fractures


Orthopaedic Trauma Association (OTA)
https://ota.org › sites › files › LE Hip6 Distal Fe...
Orthopaedic Trauma Association (OTA)
https://ota.org › sites › files › LE Hip6 Distal Fe...
PDF
by DJ Stockton — 'Modern' distal femoral locking plates allow safe, early weight-bearing with a high rate of union and low rate of failure: five-year experience from a United ...Read more
C3 Distal Femoral Fracture Plate from ota.org
Videos
AO Trauma NA Webinar—Distal Femur Fracture Management ...
YouTube · AO Trauma North America
Nov 13, 2023
YouTube · AO Trauma North America
1:02:22
Femur, Distal - Intraarticular Fracture (33C2.1) - Fixation With ...
YouTube · Pathognomonique
Dec 2, 2021
YouTube · Pathognomonique
14:52
A 33C2.1 fracture will be treated with the LCP distal femur plate or DF using the less invasive stabilization system or LIS for short.
Distal Femur: Nail, Plate, or Both?
YouTube · AO Trauma North America
Mar 25, 2021
YouTube · AO Trauma North America
1:17:33
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Web results

Highly unstable complex C3-type distal femur fracture


Springer Nature Link
https://jorthoptraumatol.springeropen.com › articles
Springer Nature Link
https://jorthoptraumatol.springeropen.com › articles
by AES Khalil · 2012 · Cited by 101 — This prospective study investigates a possible solution to these problems through double plating with autogenous bone grafting via a modified Olerud extensile ...Read more
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