title: High complication rate in locking plate fixation of lower periprosthetic distal femur fractures in patients with total knee arthroplasties.
abstract: Fixation of the distal portion of the femur in patients with total knee arthroplasties can be challenging. Locking plates have emerged as a promising treatment. Twenty-seven patients with periprosthetic distal femur fractures after total knee arthroplasties were treated using a contralateral reverse distal femoral locking plate. The average time for union and weight-bearing was 4.5 ± 2.7 months. The union rate was 89%. Thirty-seven percent experienced complications, with 2 delayed unions (7.4%), 1 nonunion (3.7%), and 7 fixation failures (26%). Alteration in blood supply and biomechanics as well as poor existing bone quality and minimal distal femur bone stock may contribute to treatment difficulties.
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio 43614, USA.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: Jiayong
authors.initials: J
authors.lastname: Liu
authors.forename: Sohaib Z
authors.initials: SZ
authors.lastname: Hashmi
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Sochacki
authors.forename: Muhammad Z
authors.initials: MZ
authors.lastname: Moral
authors.forename: Adam G
authors.initials: AG
authors.lastname: Hirschfeld
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D008297:Male; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D016474:Weight-Bearing