Minimally invasive plate osteosynthesis with dual plating for periprosthetic distal femoral fractures following total knee arthroplasty

Abstract Introduction Adequate treatment for periprosthetic distal femur fractures is challenging because of various reasons, including severe osteoporosis and distal fragments that are too small or too distal. We have introduced a new surgical technique for dual plating of periprosthetic distal femur fractures following total knee arthroplasty (TKA) and determined the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) with a dual locking compression plate (LCP). Materials and methods Between January 2010 and July 2019, 18 patients [mean age, 74.8 (68–89) years; average follow-up period, 14.8 (12–43) months] underwent MIPO with distal femoral LCP laterally and proximal humeral internal locking system (PHILOS) medially for periprosthetic distal femoral fractures following TKA. The minimum follow-up was 1 year. The clinical and radiological outcomes were assessed using the modified WOMAC scores, knee range of motion, time to callus formation, time to union, and complications of malunion, nonunion, and shortening. Results The average time to union was 18.4 weeks (range, 10–51 weeks) and to callus formation was 7.8 weeks (range, 2–14 weeks). At the 1-year follow-up, the average JLETS was 37.6 (range, 24–53), average knee ROM was 110.3° (range, 80–135°), and average varus-valgus angles of the distal femur were 3.2° (range, −2.9–10.5°). No nonunion, broken plates, or implant failure occurred. Malunion occurred in three patients. Conclusion MIPO with dual LCP is a reliable method for stabilizing periprosthetic distal femoral fractures following TKA, with satisfactory bone union rates and low complication rates.

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Minimally Invasive Plate Osteosynthesis with Dual Plating for Periprosthetic Distal Femoral Fractures Following Total Knee Arthroplasty

10.21203/rs.3.rs-94001/v1 ◽

2020 ◽

Author(s):

Yong-Geun Park ◽

Hyunseong Kang ◽

Jung-Kook Song ◽

Jaehwang Lee ◽

Joseph Y. Rho ◽

...

Keyword(s):

Distal Femur ◽

Callus Formation ◽

Plate Osteosynthesis ◽

Femoral Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Distal Femoral Fractures ◽

Femur Fractures ◽

Dual Plating ◽

One Year

Abstract Introduction: Adequate treatment for periprosthetic distal femur fractures is challenging because of various reasons, including severe osteoporosis and distal fragments that are too small or too distal. We have introduced a new surgical technique for dual plating of periprosthetic distal femur fractures following total knee arthroplasty (TKA) and determined the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) with a dual locking compression plate (LCP). Materials and methods: Between January 2010 and July 2019, 18 patients [mean age, 74.8 (68–89) years; average follow-up period, 14.8 (12–43) months)] underwent MIPO with distal femoral LCP laterally and proximal humeral internal locking system (PHILOS) medially for periprosthetic distal femoral fractures following TKA. The minimum follow-up was one year. The clinical and radiological outcomes were assessed using the modified WOMAC scores, knee range of motion, time to callus formation, time to union, and complications of malunion, nonunion, and shortening.Results: The average time to union was 18.4 weeks (range, 10–51 weeks) and to callus formation was 7.8 weeks (range, 2–14 weeks). At the one-year follow-up, the average JLETS was 37.6 (range, 24–53), average knee ROM was 110.3° (range, 80°–135°), and average varus-valgus angles of the distal femur were 3.2° (range, -2.9°–10.5°). No nonunion, broken plates, or implant failure occurred. Malunion occurred in three patients.Conclusion: MIPO with dual LCP is a reliable method for stabilizing periprosthetic distal femoral fractures following TKA, with satisfactory bone union rates and low complication rates.

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Minimally Invasive Plate Osteosynthesis for Periprosthetic Distal Femoral Fractures after Total Knee Arthroplasty

Knee Surgery and Related Research ◽

10.5792/ksrr.2014.26.1.27 ◽

2014 ◽

Vol 26 (1) ◽

pp. 27-32 ◽

Cited By ~ 9

Author(s):

Chul-Wung Ha ◽

Oog Jin Shon ◽

Seung Wan Lim ◽

Kang Hyun Park

Keyword(s):

Total Knee Arthroplasty ◽

Minimally Invasive ◽

Knee Arthroplasty ◽

Plate Osteosynthesis ◽

Femoral Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Distal Femoral Fractures ◽

Total Knee

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CLINICAL EVALUATION OF EFFICACY OF MINIMAL INVASIVE PLATE OSTEOSYN THESIS TECHNIQUE FOR SURGICAL MANAGEMENT OF SUPRACONDYLAR FEMUR FRACTURES

10.36106/ijsr/5133887 ◽

2021 ◽

pp. 67-69

Author(s):

Sumanta Panja ◽

Mujibar Rahaman Mullick

Keyword(s):

Distal Femur ◽

Femoral Fractures ◽

Locking Compression Plate ◽

Osteoporotic Bone ◽

Distal Femoral Fractures ◽

Femur Fractures ◽

Randomized Controlled Studies ◽

Compression Plate ◽

Supracondylar Femur Fractures

AIMS AND OBJECTIVES: To study Union rate (time to union), time of mobilization, functional results, radiological results, complications of supracondylar femur fractures treated by MIPO techniques with distal femur locking compression plate (DF-LCP). MATERIALANDMETHODS: This is a prospective study of 30 Patients, with supracondylar femur fractures (AO classication A) who were treated with distal femur locking compression plate (DF- LCP) by MIPO techniques at Department of Orthopaedics, SSKM & IPGMER KOLKATA from 1stJAN2015 to 31st JULY 2016.The study sample size was 30 patients and all these patients were included with predened inclusion & exclusion criteria in this study. Minimum of 12 months and a maximum of 17 months follow up were done. The functional and radiographic results were recorded according to Knee Society Score criteria. RESULTS: The average time to union was 3.93 months with a range of 2 – 7 months (8 – 28 weeks) and standard deviation being 1.13. The Mean range of exion obtained postoperatively was 108.830 with a range of 900– 1250. Six decreased knee movements, two mal-alignment, two implant failure and two infection were the residual complications in our study. Follow up of our cases included from a minimum of 12 months to a maximum of 17 months. Excellent results were seen in 3 cases, good in 10, fair in 12 and 5 case of poor results was seen. CONCLUSION: We conclude that MIPO technique with DF-LCP in distal femoral fractures is a safe and reliable option. It may substitute a conventional plate and screw system (compression method) in treatment of complex distal femoral fractures especially in osteoporotic bone. Further randomized controlled studies are required in different situations to know the usefulness of this implant.

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“FUNCTIONAL OUTCOME OF RETROGRADE NAILING IN THE MANAGEMENT OF SUPRACONDYLAR AND DISTAL FEMORAL FRACTURE”

10.36106/gjra/6411014 ◽

2021 ◽

pp. 107-109

Author(s):

Avinash Kumar Choudhary ◽

M.K Aseri ◽

Sumit Machra ◽

Devendra Singh

Keyword(s):

Femoral Fracture ◽

Distal Femur ◽

Femoral Fractures ◽

High Energy ◽

Valgus Deformity ◽

Minor Trauma ◽

Rating Score ◽

Joint Congruency ◽

Distal Femoral Fractures

INTRODUCTION: Fractures of the Distal femur are complex injuries that pose a challenge to the orthopaedic surgeon. It constitutes about 6 % of all femoral fractures. It usually occurs during high energy trauma in younger patients and frequently are associated with concomitant injuries. In contrast, elderly patients with severe osteopenia might sustain solitary distal femoral fractures from minor trauma such as a simple fall. Proper diagnosis and treatment leads to early mobilization and rehabilitation of patients. MATERIAL AND METHODS :This prospective study was conducted in Department of Orthopedics at Dr. S. N. Medical College and Associated group of Hospital, Jodhpur ,Rajasthan ,India on 30 patients who underwent the surgery with retrograde intramedullary interlocking nail in the management of extra-articular supracondylar femoral fracture from August 2019 to November 2020. On follow up axial alignment was assessed and functional analysis was quantied using NEERS RATING SYSTEM, Radiographs was analyzed for correction, maintenance of position or loss of reduction. function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients. RESULTS: In our study 30 patients with supracondylar & distal femoral fractures based on AO Classication on MULLER ET AL underwent retrograde supracondylar nail, long term nal result were rated using NEER'S RATING SCORE , which gives point for pain, function, working, joint movement ,gross and radiological appearance. NEER'S RATING SCORE assigned for each patient after 24 weeks of follow up. After accessing this score out of total 30 patients, 10 have excellent score, 10 have good score, 8 have fair score and next 2 have poor score. Function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients,out of 30 patients 9 patients have an excellent result , 8 have good ,12 have fair and only 1 patient have poor result CONCLUSION:The retrograde intramedullary locked nail provides the surgeon with a different option in treatment of specic supracondylar fracture patterns. It offers a practical advantages of simple and efcient technique for patients with polytrauma, oating knee injuries and in elderly. this technique is very useful in distal femur fracture where antegrade nailing does not provide stability and also where plate xation is not suitable due to soft tissue condition.

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