Dongwhan Suh1, Jong-Hun Ji1,2, Jun-Young Heu3, Jung-Youn Kim4, Heeman Chi1, Se-Won Lee5,6. 1. Department of Orthopedic Surgery, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea. 2. Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Department of Orthopedic Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea. 4. Department of Orthopedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 5. Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. ssewon@naver.com. 6. Department of Orthopedic Surgery, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10, 63-Ro, Yeongdeungpo-Gu, Seoul, 07345, Republic of Korea. ssewon@naver.com.
Abstract
PURPOSE: Augmenting fracture fixation with intramedullary fibular graft has seen several applications such as in comminuted proximal humerus fractures, and femoral neck and shaft nonunion. The purpose of this study was to report the first case series demonstrating the novel application of an intramedullary fibular allograft strut and dual locking plates on complicated periprosthetic fracture of distal femur. METHODS: The patient demographics, weight-bearing status, and radiographic and clinical outcomes of six patients, who were treated for periprosthetic distal femur fractures using an intramedullary fibular allograft strut and dual locking plate, between January 2018 and April 2020 were analyzed. RESULTS: Postoperative range of knee motion showed median 10' (range 10-20) of flexion contracture and 90' (range 80-110) of further flexion. Postoperative joint function was assessed according to the Kolmert functional criteria, with "excellent to good" in angular deformity and "Good to fair" result in range of motion and pain. RUSH score was assessed, and median score was 24 (range 18-26). All patients were able to ambulate without assistance 6 months after surgery. CONCLUSION: In summary, the application of fibular strut graft and dual locking plate might be an option in complicated distal femur fracture above total knee arthroplasty. Albeit with an available number, such application showed promise as an intramedullary and cortical support for both reduction and maintenance of correction alignment, length, and prevention of further angular deformity. LEVEL OF EVIDENCE IV: Surgical technique and Cases-series.
PURPOSE: Augmenting fracture fixation with intramedullary fibular graft has seen several applications such as in comminuted proximal humerus fractures, and femoral neck and shaft nonunion. The purpose of this study was to report the first case series demonstrating the novel application of an intramedullary fibular allograft strut and dual locking plates on complicated periprosthetic fracture of distal femur. METHODS: The patient demographics, weight-bearing status, and radiographic and clinical outcomes of six patients, who were treated for periprosthetic distal femur fractures using an intramedullary fibular allograft strut and dual locking plate, between January 2018 and April 2020 were analyzed. RESULTS: Postoperative range of knee motion showed median 10' (range 10-20) of flexion contracture and 90' (range 80-110) of further flexion. Postoperative joint function was assessed according to the Kolmert functional criteria, with "excellent to good" in angular deformity and "Good to fair" result in range of motion and pain. RUSH score was assessed, and median score was 24 (range 18-26). All patients were able to ambulate without assistance 6 months after surgery. CONCLUSION: In summary, the application of fibular strut graft and dual locking plate might be an option in complicated distal femur fracture above total knee arthroplasty. Albeit with an available number, such application showed promise as an intramedullary and cortical support for both reduction and maintenance of correction alignment, length, and prevention of further angular deformity. LEVEL OF EVIDENCE IV: Surgical technique and Cases-series.
Authors: Tatu J Mäkinen; Herman S Dhotar; Simcha G Fichman; Matthew J Gunton; Mitchell Woodside; Oleg Safir; David Backstein; Thomas L Willett; Paul R T Kuzyk Journal: Int Orthop Date: 2015-04-16 Impact factor: 3.075
Authors: Alexander B Christ; Harshvardhan Chawla; Elizabeth B Gausden; Jordan C Villa; David S Wellman; Dean G Lorich; David L Helfet Journal: J Orthop Trauma Date: 2018-10 Impact factor: 2.512