Intramedullary Nailing Versus Locked Plate for Treating Supracondylar Periprosthetic Femur Fractures

Horneff, John G.; Scolaro, John A.; Jafari, S. Mehdi; Mirza, Amer; Parvızı, Javad; Mehta, Samir

doi:10.3928/01477447-20130426-16

Cited by 61 publications

(42 citation statements)

References 31 publications

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“…Nine articles, totaling 461 fractures, in our study directly compared locked plating and intramedullary nailing. Five articles found no overall advantage to either method, while three articles supported locked plating and one article favored nailing 5,7,13,16,19,20,30,35,41 .…”

Section: Discussionmentioning

confidence: 96%

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

Ebraheim

Kelley

Liu

et al. 2015

Orthopaedic Surgery

109

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This study was designed to itemize and analyze the classification of fracture types and their corresponding outcomes in an attempt to provide a better understanding of the current treatment methods. Two PubMed searches were performed using the words "periprosthetic distal femur fracture" and "periprosthetic supracondylar femur fracture" in studies that were published in the previous 10 years (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014). Data from 41 articlesthat met the general inclusion criteria, were collected and categorized into fracture type and treatment method groupings. Healing outcome and complications were the two parameters used to analyze the data. Treatment techniques were grouped in the following categories: locking plate, non-locking plate, intramedullary nail/rod, screw, blade plate, cerclage wires, allograft, external fixation, revision arthroplasty, non-operative, and other. Classification systems by Lewis and Rorabeck, the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA), Su et al., Neer et al., Kim et al., Backstein et al., and the Société Française de Chirurgie Orthopédique et Traumatologique were reported. In total 448 fractures were identified, of which Rorabeck type II was the most common fracture studied. The two most successful treatment options for periprosthetic distal femur fractures were locking plate (87%) and intramedullary nail/rod (84%). The most frequent complications associated with periprosthetic distal femur fractures included non/mal/delayed union and the need for revision. Locking plates used to treat Rorabeck type II fractures had a complication rate of 35% and those treated with intramedullary nailing had a higher complication rate of 53%. In conclusion, the most frequent type of periprosthetic distal femur fracture after total knee arthroplasty was Rorabeck type II. The most common treatments for these types of fractures are locked plating and intramedullary nailing, with similar healing rates of 87% and 84%, respectively. However, the complication rate for locked plating was lower than for intramedullary nailing.

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Section: Discussionmentioning

confidence: 96%

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

Ebraheim

Kelley

Liu

et al. 2015

Orthopaedic Surgery

109

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“…Internal fixation using submuscular plating has shown excellent results in several series. [24][25][26][27] Bezwada et al found retrograde intramedullary nails superior to plate and screw fixation while Large et al found locked plates superior to conventional plates. 6,24 Horneff et al found better union rates and lower reoperation rates with lateral locked plating compared with intramedullary nailing.…”

Section: Discussionmentioning

confidence: 96%

“…6,24 Horneff et al found better union rates and lower reoperation rates with lateral locked plating compared with intramedullary nailing. 26 Despite its advantages, locked plating resulted in malunion rate of 20% with an overall complication rate of 12%. 24 In another study, Streubel et al demonstrated comparable results when lateral locked plating was used for management of proximal (Su types 1 and 2) as well as extreme distal (Su type 3) periprosthetic fractures.…”

Section: Discussionmentioning

confidence: 98%

Femoral Revision Arthroplasty for Su Type 3 Supracondylar Periprosthetic Knee Fractures

et al. 2014

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Periprosthetic distal femoral fractures can present significant reconstructive challenges when associated with poor bone stock, comminution, or component loosening. Revision arthroplasty with stemmed components or distal femoral replacement arthroplasty often becomes necessary. This retrospective study reviewed the results of femoral revision arthroplasty in 16 knees with acute, extreme distal (Su type 3), supracondylar periprosthetic fractures using cemented, midlevel constrained implants. The mean patient age was 71 years and mean follow-up was 5 years. All fractures united with mean Knee Society scores of 86 and 55, at the last follow-up. All patients returned to preinjury activity level. Complications included one valgus malunion with shortening and one reoperation for functional lateral instability. This treatment modality achieved reliable fracture union and return of function. Moreover, the final salvage option of distal femoral arthroplasty is preserved.

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“…Horneff et al [10] recommend the use of locking plated instead of intramedullary nails for the treatment of Rorabeck type II fractures because of the complications rate.…”

Section: Discussionmentioning

confidence: 99%

The number of locking screws predicts the risk of nonunion and reintervention in periprosthetic total knee arthroplasty fractures treated with a nail

Toro-Ibarguen

Moreno-Beamud

Porras-Moreno

et al. 2014

Eur J Orthop Surg Traumatol

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Periprosthetic knee fractures following total knee arthroplasty are increasing proportionally to the number of primary procedures done. We performed a retrospective review of Rorabeck type II fractures treated with a retrograde nail, trying to find the relationship between failure and the number of distal locking screws used. Twenty-six patients were included. The number of distal interlocking screws (patients with one or two distal interlocking screws and patients with three screws) correlated with nonunion (p < 0.1), did not correlate with the malunion rate (p > 0.1) and correlated with the reintervention rate (p < 0.1).

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Intramedullary Nailing Versus Locked Plate for Treating Supracondylar Periprosthetic Femur Fractures

Cited by 61 publications

References 31 publications

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

Periprosthetic Distal Femur Fracture after Total Knee Arthroplasty: A Systematic Review

Femoral Revision Arthroplasty for Su Type 3 Supracondylar Periprosthetic Knee Fractures

The number of locking screws predicts the risk of nonunion and reintervention in periprosthetic total knee arthroplasty fractures treated with a nail

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