Dual Implant Versus Single Implant Distal End of Femur

Inclusion Criteria: * Patient age 60 years or greater, * Femur fracture distal to the femoral diaphysis, * Operative treatment within 72 hours of presenting to the treating hospital, * Patient was previously ambulatory, * Fracture amendable to either single or dual implant fixation, * Informed consent can be obtained from the patient, family member, or power of attorney, * Displaced fracture (\>2.5mm displacement, native or periprosthetic) Exclusion Criteria: * Associated major lower extremity fracture, * Ongoing infection, * History of metabolic bone disease (Paget's, etc), * Pathologic fracture, * Gustilo-Anderson Type 3B/3C open fractures, * Severe cognitive impairment (Six Item Screener with 3 or more errors), * Stage 5 Parkinson's disease, * Significant femoral bone loss requiring planned staged bone grafting, * Vascular injury, * Bilateral femur fractures, * Unable to follow-up at treating institution for 12 months