Background and Objective: Femoral shaft fractures are among the most common orthopedic injuries, and improper treatment can lead to severe disability or even mortality. Although intramedullary nailing (IMN) is considered the gold standard, plate fixation is preferred in certain cases, such as pathological fractures or malunions. This study aimed to compare the clinical and radiographic outcomes of single-plate (SP) versus double-plate (DP) fixation in patients treated at Fatemi Hospital, Ardabil, during 2023–2024.
Methods: This retrospective cohort study included 40 patients (20 in each group). Evaluated variables included clinical and radiographic union times, pain scores (VAS), functional outcomes (LEFS), time to full weight-bearing, and complication rates (infection, nonunion, and implant failure).
Results: The DP group demonstrated significantly shorter clinical (17.9 vs. 21.6 weeks, P=0.011) and radiographic (19.7 vs. 24.3 weeks, P=0.008) union times. Additionally, the DP group achieved higher LEFS scores (77 vs. 68, P=0.016) and earlier weight-bearing (8.8 vs. 11.4 weeks, P=0.019). Infection rates were higher in the DP group (20% vs. 5%) but not statistically significant (P>0.05). Implant failure occurred exclusively in the SP group (15%, P=0.037). Residual pain was more frequent in the DP group (30% vs. 10%), approaching statistical significance (P=0.09).
Conclusion: Double-plate fixation provides enhanced mechanical stability and is associated with superior clinical outcomes. Therefore, it may be considered the preferred option for femoral shaft fracture stabilization, particularly in cases requiring long-term fixation.