High complication rate in locking plate fixation of lower periprosthetic distal femur fractures in patients with total knee arthroplasties.

Ebraheim, Nabil A; Liu, Jiayong; Hashmi, Sohaib Z; Sochacki, Kyle R; Moral, Muhammad Z; Hirschfeld, Adam G · J Arthroplasty · 2012

case_series · Level IV

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Abstract

Fixation of the distal portion of the femur in patients with total knee arthroplasties can be challenging. Locking plates have emerged as a promising treatment. Twenty-seven patients with periprosthetic distal femur fractures after total knee arthroplasties were treated using a contralateral reverse distal femoral locking plate. The average time for union and weight-bearing was 4.5 ± 2.7 months. The union rate was 89%. Thirty-seven percent experienced complications, with 2 delayed unions (7.4%), 1 nonunion (3.7%), and 7 fixation failures (26%). Alteration in blood supply and biomechanics as well as poor existing bone quality and minimal distal femur bone stock may contribute to treatment difficulties.

Medical subject headings

Anatomy