Modified fixation for periprosthetic supracondylar femur fractures:Two case reports and review of the literature  

作　　者：Qin-Wen Li Bin Wu Bo Chen 

机构地区：[1]Department of Orthopedics,The People's Hospital of Three Gorges University,The First People's Hospital of Yichang,Yichang 443000,Hubei Province,China

出　　处：《World Journal of Clinical Cases》2022年第33期12328-12336,共9页世界临床病例杂志

摘　　要：BACKGROUND Periprosthetic supracondylar femoral fractures(PSFs)present a challenge in terms of optimizing fixation in patients with poor bone quality.Surgical treatment and peri-operative management of PSFs in the elderly remain a burden for orthopedic surgeons.Among different treatment options,locking plate(LP)and retrograde intramedullary nail(RIMN)have shown favorable results.However,reduced mobility and protected weight-bearing are often present in the postoperative older population.With a purpose of allowing for early weight-bearing,a modified nail plate combination(NPC)was redesigned for PSF management.CASE SUMMARY In our cases,two elderly osteoporotic female underwent total knee arthroplasty(TKA),and then suffered from low energy trauma onto their knees after falling to the floor.Plain radiographs or computed tomography scans demonstrated oblique or transverse PSFs,both of which occurred at the distal femur above TKA.The modified NPC technique was performed for treatment of PSFs.The patient was made foot flat weight bearing in 1 wk.At 6-mo follow-up,the union was ultimately achieved using modified NPC with satisfactory implant outcomes.CONCLUSION Neither LP nor RIMN alone may provide adequate support to allow for union in circumstances where the patient has severely osteopenic bone.Therefore,developing a modified implant offer an alternative choice for treating PSFs.These two cases revealed that this technique is a viable option for the geriatric osteoporotic PSFs,offering safe,early weight bearing and favorable clinical outcomes.

关 键 词：Periprosthetic supracondylar femoral fracture Modified nail plate combination Elderly osteoporotic patient Early weight bearing Case report 

分 类 号：R687.3[医药卫生—骨科学]