Treatment of Periprosthetic Supracondylar Femur Fractures following Total Knee Arthroplasty: Minimally Invasive Technique using Locking Condylar Plate

PURPOSE: To evaluate clinical and radiological outcomes related to minimally invasive treatment of supracondylar periprosthetic fractures with locked condylar plates following total knee arthroplasty. MATERIALS AND METHODS: We studied 7 cases of periprosthetic supracondylar femoral fractures treated between January 2001 and June 2006. The mean patient age was 66 years (range: 62~72 years). The mean follow-up duration was 21 months (range: 12~41 months). The index operation implant was a posterior cruciate substitution implant without a stem. According to the Orthopedic Trauma Association (OTA) classification, all cases were 33A. RESULTS: Each case was treated using a locking condylar plate. The fracture was extended to the undersurface of the anterior flange of the femoral component. The locking condylar plate was fixed by minimally invasive percutaneous technique. The average time to bone union was 5 months (range: 3~6 months) without additional bone grafting. The mean range of motion was 96 degrees, and the mean Hospital for Special Surgery (HSS) score was 75 points at last follow-up. The mean femorotibial angle at last follow-up was valgus 5 degrees. CONCLUSION: Minimally invasive percutaneous fixation using a locking condylar plate was a useful alternative to a retrograde femoral nail in repairing periprosthetic femoral fractures

Volarly Displaced Epiphyseal Fracture of the Middle Phalanx: A Case Report / 대한정형외과학회잡지

A 12-year old boy sustained a volarly displaced fracture of the middle phalanx after sustaining a hyperextension injury to the fifth finger. The alignment of the proximal interphalangeal (PIP) joint was maintained and the articular surface of the displaced epiphysis faced the proximal phalangeal head. This is different from case reported elsewhere, which described volarly displaced epiphyseal fractures during the reduction of a volar PIP dislocation. This means that the pathomechanism in the present case is different from the previously reported cases. The closed reduction was successful and the hand function of the patient was satisfactory at the 6 month follow-up.