Official Journal of the Italian Society of Orthopaedics and Traumatology
Table 1 Summary of management of periprosthetic fracture of the femur
From: Periprosthetic fractures of the femur after total knee arthroplasty
Fracture type | Description of fracture | Treatment recommendation |
|---|---|---|
I | Undisplaced fracture and well-fixed prostheses | Bracing, nonweightbearing |
II | Displaced fracture and well-fixed prostheses | Â |
 A. Good-quality bone | Internal fixation using conventional plate, intramedullary nail or locking plate | |
 B. Poor-quality bone with osteopenia and comminution |  | |
 1. Decent-size distal fragment | Intramedullary nail or locking plate | |
 2. Extremely distal fracture | Locking plate or buttress plate with strut allograft | |
III | Displaced fracture, loose prostheses | Â |
 A. No metaphyseal bone loss | Revision knee arthroplasty using a long-stemmed femoral implant | |
 B. Metaphyseal bone loss or nonunion following previous surgery | Structural allograft–prostheses composite or distal femoral replacement prosthesis |