“…Many factors must be considered in choosing the most appropriate management method for these fractures including the patients general health, prefracture ambulatory status, fracture pattern, location, displacement, and type of implant (Su et al, 2004). Periprosthetic fractures above total knee arthroplasties have particular risks for failure, including wide metaphyseal and diaphyseal spaces, osteoporosis, small distal femoral fragments, and prosthetic anchorage pegs reducing the sites for fixation (Kolb et al, 2010). Surgical options include intramedullary devices, condylar buttress plates and, -more recently, -locking plates (internal fixators) that are typically placed in a submuscular manner (Herrera et al, 2008).…”