Triple fracture during rehabilitation after revision total knee arthroplasty.

Abstract

The incidence of periprosthetic fractures after knee-joint implant revisions is increasing in prevalence. We present a method of treatment for a patient who sustained a triple fracture--a periprosthetic femur fracture, a patella fracture, and a tibial shaft fracture. The femoral fracture was treated with a specially designed intramedullary nail, the patella fracture with a figure-of-eight suture, and the tibial shaft fracture by a minimal-invasive plate osteosynthesis using a percutaneous plating technique. Osseous consolidation was confirmed, and the patient presented a satisfying range of movement under full-weight-bearing conditions after mobilisation. Simultaneous multiple periprosthetic fractures are a special challenge, and in situ coupling of the endoprosthesis with a slotted hollow nail presents a valuable option for the treatment. Level V, Expert opinion.