Pediatric Lateral Condyle Fractures With Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: J.G.S. is a member of the education advisory board at OrthoPediatrics, serves as a board member of Pediatric Society of North America and research support from IONIS Pharmaceuticals. The other authors declare no conflicts of interest. 9. J Knee Surg. 2026 Jun 23. doi: 10.1055/a-2886-7879. Online ahead of print. Management of Distal Femoral Periprosthetic Fractures after Total Knee Arthroplasty: Fixation versus Revision Reconstruction. Sakalian P(1)(2), Germano J(1)(2), Scuderi GR(1)(2). Author information: (1)Northwell, New York, United States, New York. (2)Zucker School of Medicine at Hofstra/Northwell, Department of Orthopedic Surgery, New York, United States, New York. The incidence of periprosthetic distal femur fractures after total knee arthroplasty (TKA) is increasing in parallel with the increasing number of primary TKA procedures being performed. This number will continue to rise going forward. Treatment decisions depend on patient factors, fracture characteristics, and implant stability. It is important to have a thorough understanding of the available modalities for treatment, including their indications, advantages, and disadvantages, to effectively manage these injuries and optimize outcomes. Nonoperative treatment is indicated in select cases but is generally associated with inferior outcomes, including higher rates of nonunion, malunion, and medical complications secondary to prolonged immobility. Operative management is the gold standard, and options include open reduction internal fixation (ORIF) with plates and screws, intramedullary nailing (IMN), nail/plate combination constructs, and revision arthroplasty with distal femoral replacement (DFR). Locking plate fixation can be useful for comminuted or more complex fractures and poor bone stock, while IMN is less invasive, preserving biology and allowing for earlier mobilization in some cases, especially when combined with plating. DFR is indicated for cases of implant loosening or severe bone loss and has been associated with more reliable early weight-bearing at the expense of increased risks for infection and revision arthroplasty. Overall, each of the treatment modalities discussed is a viable option for the management of these complex injuries. Management should ultimately be tailored to the individual patient. The surgeon should consider patient factors, fracture characteristics, implant stability, and their own level of expertise when deciding on treatment. Thieme. All rights reserved. DOI: 10.1055/a-2886-7879