title: Triple fracture during rehabilitation after revision total knee arthroplasty.
abstract: OBJECTIVE
  The incidence of periprosthetic fractures after knee-joint implant revisions is increasing in prevalence. We present a method of treatment for a patient who sustained a triple fracture--a periprosthetic femur fracture, a patella fracture, and a tibial shaft fracture.
  
  
  METHODS
  The femoral fracture was treated with a specially designed intramedullary nail, the patella fracture with a figure-of-eight suture, and the tibial shaft fracture by a minimal-invasive plate osteosynthesis using a percutaneous plating technique.
  
  
  RESULTS
  Osseous consolidation was confirmed, and the patient presented a satisfying range of movement under full-weight-bearing conditions after mobilisation.
  
  
  CONCLUSIONS
  Simultaneous multiple periprosthetic fractures are a special challenge, and in situ coupling of the endoprosthesis with a slotted hollow nail presents a valuable option for the treatment.
  
  
  METHODS
  Level V, Expert opinion.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Klinikum Saarbruecken, Winterberg 1, 66119, Saarbruecken, Germany, christof.sabine.meyer@t-online.de.
authors.forename: Christof
authors.initials: C
authors.lastname: Meyer
authors.forename: Gabor
authors.initials: G
authors.lastname: Szalay
authors.forename: Volker
authors.initials: V
authors.lastname: Alt
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schnettler
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000534:rehabilitation; D001858:Bone Nails; D001860:Bone Plates; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010329:Patella / Q000293:injuries* / Q000601:surgery; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D026741:Physical Therapy Modalities / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D013978:Tibial Fractures / Q000209:etiology / Q000601:surgery; D016474:Weight-Bearing