Nailed cementoplasty: a salvage technique for rorabeck type II periprosthetic fractures in octogenarians.
Periprosthetic femoral fractures around a total knee arthroplasty present a surgical challenge in octogenarians with advanced osteoporosis. We describe a salvage technique combining retrograde intramedullary nailing augmented with polymethylmethacrylate cement in 5 patients followed up for a median time of 12 months. The nail/cement construct bridges the femoral canal tightly and simulates a stemmed cemented revision component. All patients had an uncomplicated recovery and returned to their preinjury functional status within 4 months. This procedure does not disrupt the soft tissue envelope around the fracture site, is easy to perform and permits immediate full range of movement. When standard retrograde nailing or plating alone is inadequate in maintaining severely osteoporotic fracture reduction, nailed cementoplasty is proposed as a salvage procedure in octogenarians unfit for lengthy interventions.
Academic Department of Trauma and Orthopaedic Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, School of Medicine, Leeds University, Great George Street, Leeds, LS1 3EX, UK.
Peter
P
Bobak
Ioannis
I
Polyzois
Simon
S
Graham
Zakareya
Z
Gamie
Eleftherios
E
Tsiridis
D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001843:Bone Cements; D002484:Cementation; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000601:surgery*; D057068:Periprosthetic Fractures / Q000601:surgery*; D019904:Polymethyl Methacrylate / Q000008:administration & dosage; D016879:Salvage Therapy
D001843:Bone Cements; D019904:Polymethyl Methacrylate