Stable Fixation and Immediate Weight-Bearing After Combined Retrograde Intramedullary Nailing and Open Reduction Internal Fixation of Noncomminuted Distal Interprosthetic Femur Fractures

Abstract

With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopaedic surgeon. Retrograde intramedullary nailing combined with open reduction internal fixation using a tissue-preserving plating technique was used in our series of 9 patients with noncomminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated after operative intervention. Every fracture healed at an average of 20 weeks (range 18-24 weeks). Use of a lateral locking plate combined with a retrograde intramedullary nailing enables immediate postoperative weight-bearing and stable fixation for patients with interprosthetic femur fractures.

Functionalization of Ti substrate with pH‐responsive naringin‐ZnO nanoparticles for the reconstruction of large bony after osteosarcoma resection

“…Compared with amputation, after tumor resection for limb‐sparing surgery, many orthopedic surgeons prefer metallic endoprosthesis for the reconstruction of large bony and soft tissue deficit (Santamaria & Cordeiro, 2006; Zeegen et al, 2004). With the stable fixation of the metal prosthesis, patients could maintain very athletic lifestyles, such as early ambulation (Hussain, Dailey, & Avilucea, 2018).…”

“…Previous studies have proved that postoperative infection after surgery had positive effects on survival in osteosarcoma patients (Yang et al, 2018). The noninfected patients had a higher 5‐year overall survival rate and event‐free survival rate than infected patients (Hussain et al, 2018). Meanwhile, local recurrence in osteosarcoma is high‐risk and associated with very poor prognosis (Gianferante et al, 2017).…”

<p>Interprosthetic femoral fractures: management challenges</p>

“…They observed a 100% union rate with immediate weightbearing. 30 Utilization of the intramedullary nail functions biologically and biomechanically. Reaming the canal for the nail allows for cancellous bone to be impacted into the fracture site after preliminary reduction with the plate.…”

“…9,14,15,28,29,[31][32][33] When permitted by a knee prosthesis that allows for the introduction of an intramedullary device, dual fixation methods to include both intramedullary nail and plate fixation as previously described may be an option in the initial treatment. 30 In the situation of an unstable knee prosthesis without a stemmed component, revision to a stemmed component with or without supplemental metaphyseal fixation may be required ( Figure 6). fixation with plate and supplemental bone augmentation as needed should follow arthroplasty component revision.…”

Investigating the biomechanics function of the plate-type external fixator in the treatment of tibial fractures: a biomechanical study

“…The bending force applied was constantly increased up to 400 N, corresponding to the bending moment of 20 Nm, at a rate of 1 mm/min. Bending stiffness was calculated by dividing the bending moment by the bending angle, and was expressed in Nm/deg [26,27]. Afterwards, sinusoidal loading with a constant amplitude was applied for each configuration.…”