Background

The British Orthopaedic Association Standards for Trauma (BOAST) for peripheral nerve injuries¹ states:

This study investigated whether this standard was met for patients with upper limb trauma at a busy London Accident and Emergency (A&E) Department.

The current incidence of periprosthetic supracondylar femoral fractures around total knee arthroplasties (TKAs) is 0.3% to 2.5%, but may well be increasing. An acceptable treatment is to insert a supracondylar nail, but not all TKAs will permit the passage of a supracondylar nail.

Method: We ascertained the ten most common TKA prostheses currently used in the United Kingdom from the National Joint Registry (NJR) Report published in September 2005. We used samples of each prosthesis with a saw bone model and checked their compatibility for accepting a supracondylar nail.

Results: We present the dimensions of the intercondylar notches of the top ten TKA prostheses, which account for over 90% of TKAs performed over the last year nationally. Our reference chart demonstrates which of these are suitable for use with supracondylar nails.

Discussion: Most of the TKAs commonly used in the UK will allow supracondylar nailing for fixation of peri-prosthetic fractures. There are, however, notable exceptions and our chart provides a quick and easy reference for knee surgeons involved in these cases.