Published online Jan 31, 2008.
https://doi.org/10.12671/jkfs.2008.21.1.19
Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail
Abstract
Purpose
Retrograde intrameullary nail is one of the treatment of periprosthetic supracondylar femoral fracture after total knee replacement (TKR), but all TKRs will not permit to insert a supracondylar nail. Therefore, we have investigated the compatibility of the TKRs with supracondylar nail.
Materials and Methods
Using trial femoral component of the 5 used TKRs in Korea and saw bone model, we checked their compatibility and measured the dimensions of the intercondylar notches in both cruciate retaining (CR) and posterior stabilized (PS) type.
Results
Although most CR prostheses had an intercondylar notch large enough to accept a supracondylar nail, in some case, this was not possible due to the notch being situated too far posteriorly. The position of the intercondylar notch is also important factor in the PS prostheses.
Conclusion
The notch position, rather than the notch size, was the most important factor in determining nail compatibility with femoral stem.
Fig. 1
Anteroposterior (A) and lateral (B) view of the photograph shows the nail's compatibility with femoral component in saw bone model.
Fig. 2
The femoral component is not compatible with the nail, despite the notch being large enough, as it is situated too posteriorly.
Table 1
The intercondylar notch dimensions of the 5 TKRA and their compatibility with supracondylar nails
References
-
Cain PR, Rubash HE, Wissinger HA, McClain EJ. Periprothetic femoral fractures following total knee arthroplsty. Clin Orthop Relat Res 1986;208:205–214.
-
-
Culp RW, Schmidt RG, Hanks G, Mak A, Esterhai JL Jr, Heppenstall RB. Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop Relat Res 1987;222:212–222.
-
-
Cusick RP, Lucas GL, McQueen DA, Graber CD. Construct stiffness of different fixation methods for supracondylar femoral fractures above total knee prostheses. Am J Orthop 2000;29:695–699.
-
-
DiGioia AM 3rd, Rubash HE. Periprosthetic fractures of the femur after total knee arthroplasty: a literature review and treatment algorithm. Clin Orthop Relat Res 1991;(271):135–142.
-
-
Healy WL, Siliski JM, Incavo SJ. Operative fixation of distal femoral fractures proximal to total knee replacement. J Bone Joint Surg Am 1993;75:27–34.
-
-
Henry SL. Management of supracondylar fractures proximal to total knee arthroplasty with the GSH supracondylar nail. Contemp Orthop 1995;31:231–238.
-
-
Hirsh DM, Bhalla S, Roffman M. Supracondylar fractures of the femur following total knee replacement. J Bone Joint Surg Am 1981;63:162–163.
-
-
Kwon JW, Shin SH, Cho WH, et al. Retrograde nailing in femur supracondylar fracture. J Korean Soc Fract 2003;16:465–473.
-
-
McLaren AC, Dupont JA, Schroeber DC. Open reduction internal fixation of supracondylar fractures above total knee arthroplasties using the intramedullary supracondylar rod. Clin Orthop Relat Res 1994;(302):194–198.
-
-
Merkel KD, Johnson EW Jr. Supracondylar fracture of the femur after total knee arthroplasty. J Bone Joint Surg Am 1986;68:29–43.
-
-
Yoo MJ, Kim MH, Park HG, Byun WS, Kim KC. Treatment of the distal femur fracture with retrograde intramedullary nailing. J Korean Fract Soc 2005;18:238–243.
-
-
Zehntner MK, Ganz R. Internal fixation of supracondylar fractures after condylar total knee arthroplasty. Clin Orthop Relat Res 1993;293:219–224.
-