title: Modern retrograde intramedullary nails versus periarticular locked plates for supracondylar femur fractures after total knee arthroplasty.
abstract: This study purpose is to analyze outcomes of modern intramedullary (IM) nails with a locked distal screw versus periarticular locking plates for peri-prosthetic supracondylar femur fractures in TKA. Ninety-five consecutive fractures in 91 patients were retrospectively reviewed. Fixation included 29 knees with a retrograde IM nail and 66 periarticular locked plates. Six patients died and 4 were lost to follow-up. There were 2 (9%) nonunions in the IM nail group and 12 non-unions/delayed-unions (19%) in the locked plate group (P = 0.34). A mean of 5.0 distal screws was used in locked plates versus 3.8 distal screws in the IM nails (P < 0.001). Despite a greater quantity of screws in the distal fragment, the failure rate of locked plating was twice that of IM nail fixation.
authors.affiliation: Department of Orthopaedic Surgery Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: R Michael
authors.initials: RM
authors.lastname: Meneghini
authors.affiliation: Department of Orthopaedic Surgery Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Keyes
authors.affiliation: Department of Orthopaedic Surgery Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Kartheek K
authors.initials: KK
authors.lastname: Reddy
authors.affiliation: Indiana Orthopaedic Hospital-OrthoIndy, Indianapolis, Indiana.
authors.forename: Dean C
authors.initials: DC
authors.lastname: Maar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: fracture union; intramedullary nail; knee replacement; locked plate; periprosthetic fracture; total knee arthroplasty