Postoperative early weight-bearing using double plating for periprosthetic, interprosthetic, and interimplant distal femur fractures following total knee arthroplasty: A report of three cases

Q4 Medicine

Trauma Case Reports Pub Date : 2024-06-09 DOI:10.1016/j.tcr.2024.101069

Nobuyoshi Watanabe , Yoshiteru Kajikawa , Tadahiko Yotsumoto , Takuro Kanda , Ryosuke Ikeda , Genji Takehara , Yasushi Oshima , Kenji Takahashi , Yoshinobu Watanabe

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引用次数: 0

Abstract

Background

Distal femur fractures (DFFs) following total knee arthroplasty (TKA) in older patients often require prolonged non-weight-bearing, thereby decreasing their activities of daily living (ADL) and increasing mortality. This report clarifies early weight-bearing safety and utility by using double-plate fixation on medial and lateral sides (LM180 double-plate fixation) for DFFs following TKA.

Case presentation

Three cases of Su Type III periprosthetic, interprosthetic, and interimplant DFFs following TKA, where bone stock was limited, were treated with LM180 double-plate fixation using locking plates through medial and lateral incisions on the distal femur. In interprosthetic and interimplant DFF cases, the proximal section was secured by overlapping the lateral plate +/− medial plate with the proximal femur stem of the intramedullary nail by using monocortical screws and cerclage wires. Early postoperative partial weight-bearing was recommended, and full weight-bearing was allowed 4–5 weeks postoperation. All cases regained independent walking without hardware failure. Average ADL scores, namely, Barthel index (BI) and functional independence measure (FIM), were recovered to 85/100 and 114.7/126, respectively, approaching near-normal values.

Conclusion

LM180 double-plate fixation for DFFs such as Su Type III periprosthetic, Vancouver type C interprosthetic, and interimplant DFFs following TKA with limited bone stock can be used to achieve early weight-bearing without fixation failure and help maintain ADL.

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全膝关节置换术后股骨远端假体周围骨折、假体间骨折和临时植入性骨折术后使用双层钢板早期负重：三例病例报告

背景老年患者在接受全膝关节置换术（TKA）后发生股骨远端骨折（DFF），往往需要长时间不负重，从而降低了他们的日常生活能力（ADL）并增加了死亡率。本报告通过使用内侧和外侧双板固定（LM180 双板固定）治疗 TKA 术后的 DFF，阐明了早期负重的安全性和实用性。病例介绍对三例 TKA 术后的苏 III 型假体周围、假体间和临时植入 DFF（骨量有限）进行了治疗，通过股骨远端内侧和外侧切口使用锁定钢板进行 LM180 双板固定。在假体间和临时植入的DFF病例中，通过使用单皮质螺钉和cerclage钢丝将外侧钢板+/-内侧钢板与髓内钉的股骨近端柄重叠固定近端部分。建议术后早期部分负重，术后4-5周可完全负重。所有病例都恢复了独立行走，没有出现硬件故障。结论LM180双板固定用于DFF，如Su III型假体周围、Vancouver C型假体间和骨量有限的TKA术后临时植入DFF，可在固定失败的情况下实现早期负重，并有助于维持ADL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.