Modern Retrograde Intramedullary Nails Versus Periarticular Locked Plates for Supracondylar Femur Fractures After Total Knee Arthroplasty

摘要

Distal periprosthetic femur fractures above total knee arthroplas-ties are difficult fractures to treat for orthopaedic surgeons. With increasing numbers of total knee arthroplasties performed, this specific complication is becoming more prevalent. The management of these fractures is complicated by several variables, which include osteoporotic bone in the distal femoral metaphyseal region, short distal segments for adequate fixation, surgical exposure and blood loss, nonunion, malunion, and malalignment. Recently, peri-articular locked plating techniques have become popular as the most common fixation method. However, consensus does not currently exist within the orthopaedic community or the peer-reviewed literature to establish which implant, fixation strategy or technique is optimal for a successful treatment outcome.The purpose of this study is to retrospectively compare the results of modern IM nails with locked distal fixation to periarticular locked plating. Our hypothesis is that the modern nails will have equivalent success to the periarticular locked plates in achieving clinical and radiographic union.