Nail–Plate Constructs for Periprosthetic Distal Femur Fractures

Mueller, G

doi:10.1055/s-0039-1683444

Cited by 20 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, considering that there was study reporting satisfactory surgical outcome after using nail-plate constructs for periprosthetic distal femur fractures, it is thought that providing sufficient fixation force is necessary to obtain satisfactory surgical results. [24]…”

Section: Discussionmentioning

confidence: 99%

Management and clinical outcomes of periprosthetic fractures after total knee arthroplasty with a stem extension

et al. 2019

View full text Add to dashboard Cite

There is little information about the management and clinical outcomes of the periprosthetic fracture after total knee arthroplasty (TKA) with a stem extension. The purposes of this study were to demonstrate management of the periprosthetic fractures after TKA with a stem extension, to report treatment outcomes, and to determine whether dual-plate fixation is superior to single-plate fixation regarding the radiographic bone union time and incidence of metal failure. This retrospective study included 15 knees with periprosthetic fractures after TKA using a stem extension. We demonstrated the fracture characteristics and management according to the fracture location and implant stability. The radiographic union time was determined. Complications, range of motion, and functional outcomes, including Western Ontario and McMaster Universities Osteoarthritis Index and Knee Society Score were assessed. Periprosthetic fractures after TKA with stem extension were 1 metaphyseal fracture without implant loosening, 7 diaphyseal fractures adjacent to the stem without implant loosening, 3 diaphyseal fractures away from the stem without implant loosening, and 4 fractures with implant loosening. Treatment included immobilization using a long leg cast, open reduction and internal fixation (ORIF), and re-revision TKA. There was no difference in functional outcomes and range of motion pre- and posttreatment. The complications included 2 cases of subsequent implant loosening. Patients in the dual-plating required a shorter bony union time than those in the single-plating (2.4 ± 1.1 vs 7.4 ± 2.2 months; P = .003). Periprosthetic fractures after TKA with stem extension could be managed individually according to the fracture location and implant stability. Complications were not uncommon even if patients were able to return to their preinjury functional level posttreatment. To avoid complications after ORIF, the dual plate was superior to the single plate, and subtle implant loosening should not be overlooked.

show abstract

Section: Discussionmentioning

confidence: 99%

Management and clinical outcomes of periprosthetic fractures after total knee arthroplasty with a stem extension

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Another construct that has been advocated for is the "nail plate combination," which also demonstrates good union rates in case series, albeit with significant added implant cost. 29,30 The technique demonstrated in this series represents a novel technique for adding medial column support in a percutaneous fashion, without adding significant operative time or implant cost. The union rates and complication profile of the supplemental medial column screw are comparable to other proposed strategies for supplemental medial fixation.…”

Section: Discussionmentioning

confidence: 99%

Technical Trick: Supplemental Medial Column Screw Fixation of Distal Femur Fractures Treated With a Laterally Based Locked Plate

Chen

Shaikh

Turvey

et al. 2023

Journal of Orthopaedic Trauma

View full text Add to dashboard Cite

Given known failure rates after lateral plating of distal femur fractures, there is an increasing interest in augmenting fixation to improve outcomes. The addition of medial plates or intramedullary nails have been described with promising results, decreasing nonunion and varus collapse rates. However, the use of dual implants increases implant costs, adds surgical complexity, and requires a second surgical approach that may increase morbidity. A supplemental, percutaneously placed, medial column screw may provide a less invasive means of improving stability and achieving fracture union compared with lateral plating alone.

show abstract

“…25 More recently, this construct has been advocated for the acute treatment of distal femur fractures, both native and periprosthetic. 26-28 The authors' preferred approach involves fracture reduction with initial plate application and subsequent nail placement (Figure 8). A midline approach is made with a lateral parapatellar arthrotomy.…”

Section: Adjunctive Fixationmentioning

confidence: 99%

Surgical Tips and Tricks for Distal Femur Plating

Lee

Brodke

Gurbani

2021

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Distal femur fractures are challenging fractures to treat, with nonunion rates as high as 22%. Precontoured locking plates have mitigated some earlier causes of failure, while introducing new challenges. The recognition of troublesome injury patterns and appropriate preoperative planning can avoid common pitfalls. Adjunctive techniques, including the use of a radiolucent triangle, an external fixator, unicortical plates, and crossing K-wires, can assist with fracture reduction and maintenance. It is important to understand the common pitfalls involved with distal femur plating and to consider a wide array of techniques to combat these challenges.

show abstract

Nail–Plate Constructs for Periprosthetic Distal Femur Fractures

Cited by 20 publications

References 11 publications

Management and clinical outcomes of periprosthetic fractures after total knee arthroplasty with a stem extension

Management and clinical outcomes of periprosthetic fractures after total knee arthroplasty with a stem extension

Technical Trick: Supplemental Medial Column Screw Fixation of Distal Femur Fractures Treated With a Laterally Based Locked Plate

Surgical Tips and Tricks for Distal Femur Plating

Contact Info

Product

Resources

About