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KMID : 0359620100220040284
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Journal of Korean Knee Society
2010 Volume.22 No. 4 p.284 ~ p.291
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Treatment for Periprosthetic Supracondylar Femur Fractures Following Total Knee Arthroplasty -Comparative Study of Retrograde Intramedullary Nailing and Locking Compression Plate Fixation-
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Kim Jin-Hak
Yoo Chang-Wook
Chun Tae-Hwan
Yang Jong-Haw
Kim Jee-Hyoung
Yang Seung-Jin
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Abstract
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Purpose: The purpose of this research is to compare the clinical and radiological results of retrograde intramedullary nailing and locking compression plate fixation. Both of these are surgical procedures for the treatment of periprosthetic supracondylar femur fractures that occur subsequent to total knee arthroplasty.
Materials and Methods : The subject population consisted of 23 cases: there were 10 cases that underwent retrograde intramedullary nailing fixation (group 1) and 13 cases that underwent use of a locking compression plate (group 2), and in both groups supracondylar femur fracture subsequent to total knee replacement occurred during the period between January 2004 and December 2008. The range of joint motion, the Hospital for Special Surgery (HSS) knee score, the tibio-femoral angle and the time to achieve bone union in each group were comparatively analyzed.
Results: The mean range of the knee joint motion decreased from 124.5˚ to 116.2˚ in group 1, and from 118.2˚ to 110.1˚ in group 2. The mean HSS knee score declined from 84.4 points to 75.8 points in group 1, and from 82.3 points to 79.0 points in group 2. The mean tibio-femoral angle changed from 6.3˚ eversion to 5.8˚ in group 1, and from 6.1˚ to 7.2˚ in group 2. The mean time to achieving bone union was 2.7 months in group 1 and 3 months in group 2.
Conclusion: Both retrograde intramedullary nailing and locking compression plate fixation, as surgical procedures for the treatment of periprosthetic supracondylar femur fractures that occur subsequent to total knee replacement, allow solid fixation and early resumption of joint movement without any statistically significant differences between the two procedures. So, both procedures appear to be good methods of treatment.
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KEYWORD
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Total knee arthroplasty, Periprosthetic fracture, Retrograde intramedullary nailing fixation, Locking compression plate fixation
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