title: Locked plating of supracondylar periprosthetic femur fractures.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Carolinas Medical Center, PO Box 32861, Charlotte, North Carolina, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Large
authors.forename: James F
authors.initials: JF
authors.lastname: Kellam
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bosse
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Sims
authors.forename: Peter
authors.initials: P
authors.lastname: Althausen
authors.forename: John L
authors.initials: JL
authors.lastname: Masonis
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D017759:Fractures, Malunited; D005599:Fractures, Ununited; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012086:Reoperation