Table 5.

Results of the systematic review for double plating of periprosthetic fractures

Title	Authors	Journal	Year	Level of evidence	Number of cases	Treatment	Mean follow-up (months)	Fracture healing	Complications	Functional outcome at final follow-up
Clinical and radiological results of patients treated with orthogonal double plating for periprosthetic femoral fractures	Müller et al.	International Orthopaedics	2014	IV	n = 10 n = 5 fractures around a total hip prosthesis n = 1 fracture around a total knee prosthesis n = 1 interprosthetic fracture n = 3 implant failure after the stabilisation of periprosthetic fractures around a total hip prosthesis n = 1 or total knee prosthesis n = 2 mean age: 79.5 years range 55–91 years	Double plating lateral plating: 13–20 holes: LISS, LCP, NCB Anterior plating: 8–14 holes: LCP	22.6 SD [6–42] 2 patients lost due to dead not related to surgery	7 of 8 fractures healed within follow-up	n = 1 1 implant failure	7 patients presented with radiologically confirmed bony consolidation with the repaired extremity bearing their full weight All patients were subjectively satisfied with their clinical outcome Therefore, 7 out 10 patients showed excellent results according to Beals and Tower
A double-plating approach to distal femur fracture: A clinical study	Steinberg et al.	Injury	2017	IV	n = 32 n = 8 periprosthetic fractures n = 24 femoral fractures including 2 non-unions and 1 open fracture mean age: 76 years range of age: 44–101 years	Lateral locking plate and medial plate	12 SD [8–20]	30 of 32 fractures healed within 12 weeks (range 6–21 weeks)	n = 5 1 delayed union 1 a shaft fracture 2 superficial wound infections 1 deep infection after union	All fractures, excluding 1 that needed bone grafting and 1 refracture, healed radiographically within a mean of 12 weeks (range 6–21 weeks) and clinically within 11 weeks (range 6–17 weeks) Axial alignment was good in all cases, but 1 fracture had a valgus of 8°. Range of motion were for extension 0°-20° and for flexion 85°–120°
An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate fixation	Çiçek et al.	Acta Orthopaedica et Traumatologica Turcica	2018	IV	n = 22 distal femur periprosthetic fractures following total knee arthroplasty Su Type 3 mean age: 73 years range of age: 68–82 years	Medial and lateral locking plate (LCP) n = 18 spongious autograft	69 SD[53–85]	20 of 22 fractures healed within 18.5 weeks (range 14.2–22.8 weeks)	n = 3 1 non-union 1 loss of reduction 1 superficial infection	Union was observed in 20 patients KSS was 81.8 ± 7.8 (range 56–90) WOMAC score was 78.1 ± 5.3 (range 62–88) ROM was 98.1° ± 8.2° (range 70°–110°) Mean time to pain-free weight bearing was 4.9 ± 1.1 (range 4–8) months
Dual plate fixation results in improved union rates in comminuted distal femur fractures compared to single plate fixation	Bologna et al.	Journal of Orthopaedics	2019	IV	n = 21 distal femoral fractures n = 13 treated with lateral distal femoral locking plate (single plate) n = 8 treated with precontoured distal femoral locking plate lateral and straight locking plate anteromedial (double plating) Mean age: 61 years Range of age: n.a	Standard lateral approach Lateral distal femoral locking compression plate (single plate) Extensile parapatellar approach (double plating) Precontoured distal femoral locking plate was placed along the lateral distal femur, a straight locking plate was placed to the anteromedial surface of the distal femur	12 [6–29]	Single plate: 4 of 13 healed Dual plate: 8 of 8 healed	Single plate: n = 10 6 non-unions 3 delayed unions 1 infection Dual plate: n = 4 2 significant knee stiffness 2 mild anterolateral heterotopic ossifications	Single plate: knee range of motion 100° (92.5–115º) Dual plate: knee range of motion 90° (70.0–90.0°)
Excellent outcomes after double-locked plating in very low periprosthetic distal femoral fractures	Park et al.	Archives of Orthopaedic and Trauma Surgery	2020	IV	n = 21 distal femur periprosthetic fractures following total knee arthroplasty Su Type 3 Mean age: 76 years range of age: 56–90 years	Lateral: LCP Medial: LCP and Philos to the distal femur	12	20 of 21 fractures healed within 14 weeks (range 10–21 weeks)	n = 8 1 non-union 3 superficial infection 4 soft tissue healing	Of the 21 fractures, 20 (95%) healed primarily within 14 weeks (range 10–21 weeks). All cases achieved satisfactory limb alignment, with an m-LDFA of 89.6º (range 85–92°) and m-PDFA of 86.5º (range 70–130°) on average Average ROM: 114° (range 70–130°) The mean Knee Society knee and function scores were 94 (range 83–100) and 89.5 (range 76–99), respectively