Percutaneous Plating of the Medial Distal Femur: Cadaveric Dissection

Abstract

Percutaneous medial plating of distal femur fractures, particularly comminuted fractures, offers improved biomechanical stability without the soft tissue insult of an open approach. The addition of a medial plate neutralizes the cantilever bending force that arises from the offset between the single lateral locking plate and the femur's anatomical axis. This cantilever bending force has been theorized to be a contributor to the high nonunion rate of distal femur fractures. Although concerns about the proximity of the superficial femoral artery have previously limited widespread adoption of medial plating, there is a considerable medial distal femur safe zone where the superficial femoral artery is not at risk. In cases where supplemental medial fixation would be beneficial and soft tissue or host limitations prevent open instrumentation, percutaneous medial plating is a safe and effective alternative.