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. 2014 Jul;29(7):1478-81.
doi: 10.1016/j.arth.2014.01.025. Epub 2014 Jan 28.

Modern retrograde intramedullary nails versus periarticular locked plates for supracondylar femur fractures after total knee arthroplasty

R Michael Meneghini  1 , Brian J Keyes  1 , Kartheek K Reddy  1 , Dean C Maar  2
Affiliations

Modern retrograde intramedullary nails versus periarticular locked plates for supracondylar femur fractures after total knee arthroplasty

R Michael Meneghini et al. J Arthroplasty. 2014 Jul.

Abstract

This study purpose is to analyze outcomes of modern intramedullary (IM) nails with a locked distal screw versus periarticular locking plates for peri-prosthetic supracondylar femur fractures in TKA. Ninety-five consecutive fractures in 91 patients were retrospectively reviewed. Fixation included 29 knees with a retrograde IM nail and 66 periarticular locked plates. Six patients died and 4 were lost to follow-up. There were 2 (9%) nonunions in the IM nail group and 12 non-unions/delayed-unions (19%) in the locked plate group (P = 0.34). A mean of 5.0 distal screws was used in locked plates versus 3.8 distal screws in the IM nails (P < 0.001). Despite a greater quantity of screws in the distal fragment, the failure rate of locked plating was twice that of IM nail fixation.

Keywords: fracture union; intramedullary nail; knee replacement; locked plate; periprosthetic fracture; total knee arthroplasty.

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