Outcomes After Distal Femur Replacement for Fracture: A Multi-Institutional Retrospective Review.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: D. C. Landy is on the editorial or governing board for American Journal of Sports Medicine and is a paid presenter or speaker for Smith & Nephew. S. T. Duncan is a paid consultant for Bone Support, Heron, Heraeus, OrthAlign, Smith & Nephew, and Zimmer; receives research support from Bone Support, Medtronic, Smith & Nephew, and Zimmer; is on the editorial or governing board for Journal of Arthroplasty, Journal of Knee Surgery, Journal of the American Academy of Orthopaedic Surgeons; is a board or committee member for Kentcuky Orthopaedic Society; has stock or stock options in MiCare and Rom3; and receives IP royalties from Smith & Nephew. M. T. Archdeacon reports other professional activities from Stryker. W. T. Obremskey reports other professional activities from Orthopedic Trauma Association. J. M. Lawrenz is a board or committee member for Musculoskeletal Tumor Society. C. Lee is a paid presenter or speaker for DePuy, Johnson & Johnson Company; reports IP royalties from Globus Medical; is a paid consultant for Globus Medical, Smith & Nephew, Stryker, and Synthes; and is on the board or committee member for Orthopaedic Trauma Association. A. Aneja reports honoraria from the Arbeitsgemeinschaft fur Osteosynthesefragen Foundation and research support from the Orthopaedic Trauma Association, American Orthopaedic Foot and Ankle Society, and United States Department of Defense. A. Aneja is a board or committee member for American Academy of Orthopaedic Surgeons and Orthopaedic Trauma Association. The remaining authors report no conflict of interest. 18. Injury. 2015 Dec;46(12):2293-6. doi: 10.1016/j.injury.2015.11.009. What is new in distal femur periprosthetic fracture fixation? Tosounidis TH(1), Giannoudis PV(2). Author information: (1)Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, UK. (2)Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, UK. Electronic address: pgiannoudi@aol.com. Distal femoral periprosthetic fractures are on the rise. Increased mortality of these injuries is also evident from recent data. Their incidence and risk factors have been extensively reported in the past but new data are being available that merit attention. The increased incidence and the even higher projected incidence should direct the focus of future strategies to the education of surgeons, relevant capacity of hospital and reconfiguration of health care resources. New and potentially modifiable risk factors should be taken into consideration to the informed consent process and new studies should be developed to clarify the causative relationship of the new risk factors such as the peptic ulcer disease and the COPD. The main internal fixation techniques remain the lateral locking plating and the retrograde intramedullary nailing. New techniques in plating are the supplementary medial plate in selected cases and the far cortical locking. Nailing is considered a valid option especially in fractures located well above the anterior flange of the femoral component of the arthroplasty. Results and outcomes from good quality studies are still sparse regarding the comparison between plating and nailing. Interprosthetic fractures constitute an entity that is lately gaining considerable attention. The best method of management of these injuries is still evolving with considerable amount of work being done in the clinical and biomechanical level. DOI: 10.1016/j.injury.2015.11.009