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Locked Plating of Supracondylar Periprosthetic Femur Fractures

2008; Elsevier BV; Volume: 23; Issue: 6 Linguagem: Inglês

10.1016/j.arth.2008.04.021

1532-8406

Thomas M. Large, James F. Kellam, Michael J. Bosse, Stephen H. Sims, Peter L. Althausen, John L. Masonis,

Orthopedic Infections and Treatments

Fifty periprosthetic supracondylar femur fractures above a total knee arthroplasty were reviewed. Fractures were closed Lewis and Rorabeck type II with a stable prosthesis. Twenty-nine patients (group I), were treated with locked condylar plating. Twenty-one patients (group II) were treated with nonlocked plating systems or intramedullary fixation. Minimum follow-up was 1.7 years. There were 5 malunions (20%) in group I and 9 (47%) in group II (P < .05). There were no nonunions in group I and 3 (16%) in group II. Complication rates were 12% in group I, compared to 42% in group II. Group I patients had less operative blood loss, healed in better alignment, and had greater knee motion. All 7 patients treated with a retrograde intramedullary nail developed a malunion or nonunion. Locked plating is a reliable treatment for periprosthetic supracondylar femur fractures. We experienced a lower complication, revision, malunion, and nonunion rate with locked plating versus conventional treatment options.