Abstract
Periprosthetic fractures around Total Knee Arthroplasty are potentially devastating complication to both the patients and the surgeons. The reported prevalence of supracondylar femoral fractures following Total Knee Replacement has ranged from 0.3 to 2.5 percent. The complication rates of various treatment modalities reported in literature varies from 25 to 70 percent.
Aim: The purpose of this study is to evaluate the outcome of Antegrade Nailing and Wire fixation in Supra-condylar femoral periprosthetic fractures.
Material & Methods: Seven patients who sustained complex distal femoral fractures above Total Knee Arthroplasty all treated by New technique of Ante-grade intramedullary Nailing and intramedullary bi-wire fixation through greater trochanteric approach without opening the distal femur were retrospectively evaluated.
Results: All the patients demonstrated uncomplicated postoperative follow-ups and returned to weight bearing between 2 and 3 months. The average age of patient was 70 (55–90) years. All fractures healed in a satisfactory alignment in average duration of 12.6 weeks. There was no wound infection, loss of reduction or implant failure. The average range of movement of knee was 86 degrees.
Conclusion: The Antegrade Nail with Wires is a simple & effective method of treating displaced periprosthetic fractures proximal to Total Knee Arthroplasy. This involves less soft tissue dissection, less operative time and satisfactory bony healing even in poor quality bones while maintaining adequate range of movements of the knee.
Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
