Periprosthetic supracondylar femoral fractures above a total knee replacement: compatibility guide for fixation with a retrograde intramedullary nail

Abstract

The incidence of total knee arthroplasty (TKA) is increasing, as are periprosthetic supracondylar femoral fractures. Treatment is complex and may involve the use of a retrograde intramedullary femoral nail, and it is essential to know the nail will fit through the femoral prosthesis in line with the intramedullary canal. Knowledge of certain measurements is crucial i.e. minimal intercondylar distance and the position of the notch on the femoral component in relation to the intramedullary canal. A review of TKA prostheses dimensions and their compatibility with a retrograde nail was obtained directly from the manufacturers. A comprehensive data set lists manufacturer, model, size, minimal intercondylar notch distance and position. This will be of practical use when planning the operative management of periprosthetic supracondylar femoral fractures.

Keywords: intercondylar distance; intramedullary nail; periprosthetic fracture; retrograde nail; supracondylar; total knee arthroplasty; total knee replacement.