Short-term outcomes of periprosthetic compared to native distal femur fractures, a national database study

Upfill-Brown, Alex; Arshi, Armin; Sekimura, Troy; Lee, Christopher; Stavrakis, Alexandra I.; Sassoon, Adam

doi:10.1007/s00402-021-04000-0

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…The most common fracture pattern seen in NDFF undergoing reoperation was complete articular (AO/OTA 33C), and the most common etiology for UROR was for irrigation and debridement of the index fracture due to infection, re ective of the more severe soft tissue injury and propensity for open fractures. Up ll-Brown et al previously conducted a large retrospective review which found no signi cant differences in 30-day reoperation rates between PDFF and NDFF [15]. However, their study did not account for mechanism or fracture complexity.…”

Section: Discussionmentioning

confidence: 95%

“…Regarding treatment, lateral plating and retrograde intramedullary nailing (rIMN) have been reported as the most common and successful xations for both PDFF and NDFF, although intramedullary nail-plate combination (NPC) xation has recently been developed as an additional treatment alternative [10], [11], [12] [13], [14]. Studies report similar 30-day and 90-day outcomes, though longer-term outcomes and reduction quality have yet to be studied [15], [16].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Differences Between Periprosthetic and Native Distal Femur Fractures

Kong,

Bautista,

Haffner

et al. 2024

Preprint

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Introduction Periprosthetic distal femur fractures (PDFF) are becoming more prevalent as total knee replacements become more common. This study compares the demographics, fracture characteristics, treatment, and outcomes of periprosthetic versus native distal femur fractures (NDFF). Materials and Methods This is a retrospective cohort study of patients ≥ 18 who underwent surgical fixation of NDFF or PDFF from 2012-2020 at a level-1 trauma center. Primary outcomes included demographics, AO/OTA fracture classification, fixation construct, and unexpected return to the operating room (UROR). Secondary outcomes were concomitant fractures, polytrauma rates, low bone density, and reduction quality. T-test, Fisher’s exact test, and multivariable analysis were used for statistical analysis. Results 209 patients were identified, including 70 PDFF and 139 NDFF. PDFF patients were elderly females (81%) with isolated (80%) and comminuted (85%) 33A.3 (71%) fractures. NDFF patients included 53% females, were commonly middle-aged, and displayed comminuted (92%) 33C.2 fractures. 48% of NDFF patients had concomitant fractures. Intramedullary nailing was the primary fixation for both groups, followed by nail-plate combination (37%) for PDFF and lateral locking plates (21%) for NDFF. NDFF patients experienced lengthier hospital stays and higher UROR rates (p<0.05). PDFF patients had a significantly higher prevalence of low bone density (p<0.05). Conclusion PDFF occur as isolated injuries with significant metaphyseal comminution in elderly females with low bone quality. NDFF commonly occurs in younger patients with less metaphyseal comminution and concomitant fractures. Intramedullary nailing was the most common treatment for both groups, though preference for nail-plate combination fixation is increasing. NDFF type 33C fractures are at higher risk of UROR.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Clinical Differences Between Periprosthetic and Native Distal Femur Fractures

Kong,

Bautista,

Haffner

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Clinical differences between periprosthetic and native distal femur fractures: a comparative observational study

Kong,

Tse,

Saade

et al. 2024

J Orthop Surg Res

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Introduction The incidence of periprosthetic distal femur fractures (PDFF) is increasing as the number of total knee replacements becomes more common. This study compared the demographics, fracture characteristics, treatment, and outcomes of periprosthetic versus native distal femur fractures (NDFF). Materials and methods This was a retrospective cohort study of patients ≥ 18 who underwent surgical fixation of NDFF or PDFF from 2012 to 2020 at a level-1 trauma center. The main variables collected included demographics, AO/OTA fracture classification, fixation construct, concomitant fractures, polytrauma rates, bone density, and reduction quality. Primary outcomes were unexpected return to the operating room (UROR), hospital length of stay, and quality of reduction. T-tests, Fisher’s exact tests, and multivariate analyses were used for statistical analysis. Results 209 patients were identified, including 70 PDFF and 139 NDFF. PDFF patients were elderly females (81%) with isolated (80%) and comminuted (85%) 33 A.3 (71%) fractures. NDFF patients included 53% females, were commonly middle-aged, and displayed comminuted (92%) 33 C.2 fractures. 48% of NDFF patients had concomitant fractures. Intramedullary nailing was the primary fixation for both groups, followed by nail-plate combination (37%) for PDFF and lateral locking plates (21%) for NDFF. NDFF patients experienced significantly longer hospital stays, higher UROR rates, and worse quality of reduction (p < 0.05). PDFF patients had a significantly greater prevalence of low bone density (p < 0.05). Conclusion PDFF occur as isolated injuries with significant metaphyseal comminution in elderly females with low bone quality. NDFF commonly occurs in younger patients with less metaphyseal comminution and concomitant fractures. Intramedullary nailing was the most common treatment for both groups, although preference for nail-plate combination fixation is increasing. NDFF type 33 C fractures are at greater risk of UROR.

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Short-term outcomes of periprosthetic compared to native distal femur fractures, a national database study

Cited by 2 publications

References 44 publications

Clinical Differences Between Periprosthetic and Native Distal Femur Fractures

Clinical Differences Between Periprosthetic and Native Distal Femur Fractures

Clinical differences between periprosthetic and native distal femur fractures: a comparative observational study

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