title: Fixation of supracondylar femoral fractures following total knee arthroplasty: is there any difference comparing angular stable plate fixation versus rigid interlocking nail fixation?
abstract: BACKGROUND
  Literature does not provide any reliable comparison between angular stable plate fixation and rigid nail fixation for stabilization of supracondylar periprosthetic femoral fractures. Thus, the purpose of this study was to compare these two implants in clinical practice relating to fracture healing, functional results and treatment-related complications.
  
  
  METHODS
  In this retrospective study (level IV), clinical and radiographic records of 86 patients (62 female and 24 male, average age: 75.6) with supracondylar periprosthetic femoral fractures between 1996 and 2010 were analyzed. 48 patients underwent lateral plate fixation by an angular stable plate system (LISS), whereas 38 patients were stabilized by a rigid interlocking nail device.
  
  
  RESULTS
  Sixty-four (76 %) patients returned to their pre-injury activity level and were satisfied with their clinical outcome. We had an overall Oxford outcome score of 2.21, with patients following angular stable plate fixation of 2.22, and patients after rigid nail fixation of 2.20. Successful fracture healing within 6 months was achieved in 74 (88 %) patients. Comparing between plate fixation and nail fixation, statistical analysis did not reveal any significant differences. Overall, we had a relatively high rate of fracture healing and a satisfactory functional outcome with both implants. Both methods of fixation showed similar results relating to the functional outcome and individual satisfaction of the patients. However, with regards to fracture healing and treatment-related complications, intramedullary nail fixation showed slight advantages.
authors.affiliation: Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Silke
authors.initials: S
authors.lastname: Aldrian
authors.forename: Rupert
authors.initials: R
authors.lastname: Schuster
authors.forename: Nicole
authors.initials: N
authors.lastname: Haas
authors.forename: Jochen
authors.initials: J
authors.lastname: Erhart
authors.forename: Markus
authors.initials: M
authors.lastname: Strickner
authors.forename: Beate
authors.initials: B
authors.lastname: Blutsch
authors.forename: Simon
authors.initials: S
authors.lastname: Wernhart
authors.forename: Johannes
authors.initials: J
authors.lastname: Leitgeb
authors.forename: Patrick
authors.initials: P
authors.lastname: Platzer
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome