Proposta de tratamento com enxerto ósseo cortical homólogo para a fratura distal do fêmur pós-artroplastia total do joelho / Treatment of distal femoral fractures above total knee arthroplasty with cortical bone allograft

RESUMO

Distal femoral fractures above total knee replacement are challenging surgical problems, specially when the components are well fixed to the bone. Many methods of treatment are described in the literature. The author suggests a new technique, employing cortical strut grafts provided by cadaver donors. Satisfactory fixation allows for early mobilization of the knee. Fracture healing and allograft incorporation to the femur can be obtained in this way. The author presents a case with satisfactory results regarding consolidation of the fracture. Range of motion is 90 degrees. One concern in using structural bone grafts is midterm resorption and failure of the reconstruction. In this technique this is not a problem, since the grafts are employed to stabilize the fracture and act as a strut. Long-term results are necessary to evaluate the effects in the loosening rates of the implant. At this moment, this new method is satisfactory with respect to healing in this problematic fracture