Our Experiences With the Treatment of Periprosthetic Fractures of Femur

Expandable Retrograde Nail for Femoral Fracture above a Total Knee Replacement

“…RIMN is one of the options for osteosynthesis of type 2 fractures. Biomechanically nails have higher bending capacity to shear forces than plates [13]. Besides this, operative time, perioperative blood loss and infection risk is lower with intramedullary nailing.…”

“…Besides this, operative time, perioperative blood loss and infection risk is lower with intramedullary nailing. In patients treated with intramedullary nailing fracture union rate is higher and knee range of motion is better [1,7,9,11,13,19] .…”

“…Despite these advantages classic RIMN's are surpassed by locking plates in current practice. The main reason for this was the small size of femoral component box rendering insertion of classic RIMN's impossible [1,5,13]. In such a situation expansion of the intercondylar notch of femoral component with a diamond burr is recommended by some authors [20].…”

“…The most prevalent type of periprosthetic fracture is the Rorabeck type 2 [1,[9][10][11][12]. Recommended treatment options are plating, external fixation and retrograde intramedullary nailing (RIMN) [1,4,13,14]. There is still continuing debate which treatment option is optimal for these patients [1,4,7,13].…”

“…Recommended treatment options are plating, external fixation and retrograde intramedullary nailing (RIMN) [1,4,13,14]. There is still continuing debate which treatment option is optimal for these patients [1,4,7,13]. There is no consensus on the technique to be used but logically it must be minimally invasive to decrease mortality and morbidity [6,7,14] .…”