Infection after an open supracondylar fracture above a total knee arthroplasty treated with the supracondylar nail.

A 72-year-old man with an open fracture above a total knee arthroplasty was treated with a supracondylar intramedullary nail. Five months after internal fixation, the patient developed a Staphylococcus aureus infection of the knee, which resolved after a 42-day course of IV antibiotics. After reimplantation with a posteriorly stabilized condylar total knee arthroplasty using femoral and tibial stems with vancomycin-impregnated cement, the patient has been pain-free and ambulatory at 8 months' follow-up. The supracondylar nail may be an acceptable internal fixation device for closed fractures above a total knee arthroplasty, but, if possible, open fractures in this location may be better treated with fixation devices that do not violate the knee joint.