Retrograde nailing of the distal femoral periprosthetic fractures using DFN

Czech version

Authors: Tomáš Nedvěd; Karel Edelmann; Petr Obruba; Renata Dohnalová; Jan Houser
Authors‘ workplace: Department of traumatology, Masaryk hospital, Ústí nad Labem ; II. chirurgické oddělení- úrazové centrum, Masarykova nemocnice, Ústí nad Labem
Published in: Úraz chir. 15., 2007, č.3

Overview

Introduction:
Periprosthetic distal femoral fractures can be treated conservatively or surgically. The way of treatment is based on the clasification of these fractures according to Lewis et al.

Material and methods:
Authors provide their experience with retrograde nailing of distal femoral periprosthetic fractures using DFN (Synthes) gained during 1999–2006 retrospectively. Group of 16 patients was treated by intramedullary nail DFN.

Results:
15 patients had good bone healing without complications, infection was detected in 1 case. Authors used Rorabeck criterion to eva-luate the functional results of surgical solution. 14 patients had range of motion of the knee, flexion >=90 deg., 2 patients less than 90 deg., but it was the same situation as before injury. There was deficiency of extension about 15 deg. in one case (4 years immobile patient). There were 2patients with valgus or varus deviations up to 5 deg.

Conclusion:
These types of fractures require specialized treatment in departments of orthopaedics and traumatology.

Keywords:
DFN - distal femoral nail, periprosthetic fracture of the distal femur, TKA - total knee arthroplasty, LISS - less invasive stabilization system.

Sources

1. Ito, K., Grass, R., Zwipp, H. Internal fixation of supracondylar femoral fractures: comparative biomechanical performance of the 95 degree plate and two retrograde nails. J Orthop Trauma. 1998, 12, 259–266.

2. Lewis, P.L., Rorabeck, C.H., Angliss, R.D. Fractures of the femur, tibia and patella after total knee arthroplasty: decision making and principles of management. Instr Course Lect. 1998, 47, 449–460.

3. Rorabeck, C.H., Tailor, J.W. Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin North Am. 1999, 30, 265–277.

4. Seifert, J., Stengel, D., Matthes et al. Retrograde fixation of distal femoral fractures: results using a new nail systém. J Orthop Trauma. 2003, 17, 488–495.

5. Tile, M., Kellam, J., Sims, S. Periprosthetic frac-tures about total knee arthroplasty- how to manage? AO Dialogue. 2006, 3, 36–39.

6. Wick, M., Miller, E.J., Kutscha-Lissberg, F. et al. Periprosthetic supracondylar Fractures: LISS or retrograde intramedullary nailing? Probleme with use of minimally invasive techniques. Unfallchirurg. 2004, 107, 181–188.

Labels

Surgery Traumatology Trauma surgery

Flail chest – weighty complications of conservative therapy (internal pneumatic stabilization)

NECROSIS OSSIS LUNATI – TREATMENT ACCORDING TO OPERATION SEC SAFFAR

Article was published in

Trauma Surgery

2007 Issue 3