Skip to main content
Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

Download PDF
  • Original
  • Published:

Supracondylar nailing of periprosthetic fractures above total knee arthroplasties

Journal of Orthopaedics and Traumatology volume 8, pages 177–181 (2007)Cite this article

Abstract

Supracondylar nailing was performed in 10 patients who sustained periprosthetic fractures above total knee arthroplasties. The fractures occurred in women with an average age of 67.4 years (range, 42–92 years). All fractures healed in a satisfactory alignment in an average duration of 13.2 weeks (range, 12–18 weeks). None of the fractures needed bone grafting. There were no cases of wound infections, nonunion or delayed union. All patients achieved satisfactory range of movement of the knee joint and preoperative functional status. Main complications included loosening of a distal screw in one patient and fracture above the short nail following a second injury in another patient. Use of a longer nail where possible and a condylar bolt for distal locking can easily avoid these complications. We conclude that supracondylar nailing, despite some limitations, is a satisfactory method of treatment for a majority of displaced periprosthetic fractures above well-fixed total knee arthroplasties.

References

  1. Culp RW, Schmidt RG, Hanks G, Mak A, Esterhai JL, Heppenstall RB (1987) Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop 222:212–222

    PubMed  Google Scholar 

  2. Merkel KD, Johnson EW (1986) Supracondylar fracture of the femur after total knee arthroplasty. J Bone Joint Surg Am 68:29–43

    CAS  PubMed  Google Scholar 

  3. Delport PH, Van Audekercke R, Martens M, Mulier JC (1984) Conservative treatment of ipsilateral supracondylar femoral fracture after total knee arthroplasty. J Trauma 24:846–849

    Article  CAS  PubMed  Google Scholar 

  4. Healy WL, Siliski JM, Incavo SJ (1993) Operative treatment of distal femoral fractures proximal to total knee replacements. J Bone Joint Surg Am 75:27–34

    CAS  PubMed  Google Scholar 

  5. Short WH, Hootnick DR, Murray DG (1981) Ipsilateral supracondylar femur fractures following knee arthroplasty. Clin Orthop 158:111–116

    PubMed  Google Scholar 

  6. Kregor PJ, Hughes JL, Cole PA (2001) Fixation of distal femoral fractures above total knee arthroplasty utilizing the less invasive stabilization system (L.I.S.S.). Injury 32[Suppl 3]:64–75

    Article  Google Scholar 

  7. Raab GE, Davis CM (2005) Early healing with locked condylar plating of periprosthetic fractures around the knee. J Arthroplasty 20:984–989

    Article  PubMed  Google Scholar 

  8. Ricci WM, Loftus T, Cox C, Borrelli J (2006) Locked plates combined with minimally invasive insertion technique for the treatment of periprosthetic supracondylar femur fractures above a total knee arthroplasty. J Orthop Trauma 20:190–196

    Article  PubMed  Google Scholar 

  9. Jabczenski FF, Crawford M (1995) Retrograde intramedullary nailing of supracondylar femur fractures above total knee arthroplasty. A preliminary report of four cases. J Arthroplasty 10:95–101

    Article  CAS  PubMed  Google Scholar 

  10. Murrell GAC, Nunley JA (1995) Interlocked supracondylar intramedullary nails for supracondylar fractures after total knee arthroplasty. J Arthroplasty 10:37–42

    CAS  PubMed  Google Scholar 

  11. Rolston LR, Christ DJ, Halpern A, O’Connor PL, Ryan TG, Uggen WM (1995) Treatment of supracondylar fractures of the femur proximal to a total knee arthroplasty. J Bone Joint Surg Am 77:924–931

    CAS  PubMed  Google Scholar 

  12. Weber D, Pomeroy DL, Schaper LA, Badenhausen WE, Curry JI, Smith MW, Suthers KE (2000) Supracondylar nailing of distal periprosthetic femoral fractures. Int Orthop 24:33–35

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Gliatis J, Megas P, Panagiotopoulos E, Lambiris E (2005) Midterm results of treatment with a retrograde nail for supracondylar periprosthetic fractures of the femur following total knee arthroplasty. J Orthop Trauma 19:164–170

    Article  PubMed  Google Scholar 

  14. Cordeiro EN, Costa RC, Carazzato JG, Silva JDS (1990) Periprosthetic fractures in patients with total knee arthroplasties. Clin Orthop 252:182–189

    PubMed  Google Scholar 

  15. Srinivasan K, Macdonald DA, Tzioupis CC, Giannoudis PV (2005) Role of long stem revision knee prosthesis in periprosthetic and complex distal femoral fractures: a review of eight patients. Injury 36:1094–1102

    Article  PubMed  Google Scholar 

  16. Kassab M, Zalzal P, Azores GMS, Pressman A, Liberman B, Gross AE (2004) Management of periprosthetic femoral fractures after total knee arthroplasty using a distal femoral allograft. J Arthroplasty 19:361–368

    Article  PubMed  Google Scholar 

  17. Springer BD, Sim FH, Hanssen AD, Lewallen DG (2004) The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop 421:181–187

    Article  PubMed  Google Scholar 

  18. Figgie MP, Goldberg VM, Figgie HE, Sobel M (1990) The results of treatment of supracondylar fracture above total knee arthroplasty. J Arthroplasty 5:267–276

    Article  CAS  PubMed  Google Scholar 

  19. Bong MR, Egol KA, Koval KJ, Kummer FJ, Su ET, Iesaka K, Bayer J, Di Cesare PE (2002) Comparison of the LISS and a retrograde-inserted supracondylar intramedullary nail for fixation of a periprosthetic distal femur fracture proximal to a total knee arthroplasty. J Arthroplasty 17:876–881

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 170 Woodhouse Lane Sale, Cheshire, M33 4LN, UK

    A. Kumar

  2. Department of Orthopaedics, Toronto East General Hospital, Toronto, Ontario, Canada

    A. Kumar, M. Catre & P. Weiler

  3. Department of Orthopaedics, Russells Hall Hospital, Dudley, West Midlands, UK

    S. Butt

Authors
  1. A. Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Catre
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Weiler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Butt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Kumar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kumar, A., Catre, M., Weiler, P. et al. Supracondylar nailing of periprosthetic fractures above total knee arthroplasties. J Orthopaed Traumatol 8, 177–181 (2007). https://doi.org/10.1007/s10195-007-0086-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10195-007-0086-8

Key words