AI Article Synopsis
- Periprosthetic fractures of the distal femur are challenging to treat, with significant variations based on the patient's condition and the fracture type.
- The study analyzed 36 patients classified using the Su et al. system, finding that most Type I and II fractures were effectively treated with a locking plate, while some Type III fractures required more extensive surgery due to implant loosening.
- Results indicated that 83.3% of patients achieved acceptable healing, with Type I fractures healing faster than Types II and III, although a higher rate of revision was needed for the latter two types.
- The findings support the use of the Su et al. classification in guiding treatment decisions and suggest that locking plates are generally effective, except in cases of implant loosening
Article Abstract
Background: Periprosthetic fractures of the distal femur remain a challenge to treat due to variations in both patient- and fracture-specific factors. This study was designed to analyze the outcomes of different subtypes of periprosthetic distal femur fractures based on the Su et al. classification system.
Methods: Thirty-six patients were classified with Su et al. system. All Type I and II fractures were managed with a locking plate. Most Type III fractures were managed with locking plate, while two were managed with long-stem revision arthroplasty due to evidence of implant loosening. Outcomes were measured and analyzed based on healing time, revision rate, and complication rate.
Results: Of the 36 patients, 30 (83.3%) achieved acceptable fracture union, while the remaining 6 (16.7%) experienced either delayed union or non-union. Type I fractures showed a significantly lower healing time than Type II and III fractures managed by locking plate. Delayed union was present in the Type II group, while non-union was recorded for two Type III fractures. Need for revision was more prevalent in fracture Types II and III.
Conclusion: The Su et al. system of classification for periprosthetic fractures of the distal femur matches the clinical outcomes of this study and would seem to be useful in the approach to the treatment of these fractures. The majority of these fractures can be managed with locking plate with reasonable results. However, if the implant is loosened in Type III fractures, revision arthroplasty is suggested.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486061 | PMC |
| http://dx.doi.org/10.1016/j.jor.2022.09.005 | DOI Listing |
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