Treatment of periprosthetic femoral fractures of the knee.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_5F09F27F004E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Treatment of periprosthetic femoral fractures of the knee.
Périodique
Knee Surgery, Sports Traumatology, Arthroscopy
Auteur(s)
Ehlinger M., Adam P., Abane L., Rahme M., Moor B.K., Arlettaz Y., Bonnomet F.
ISSN
1433-7347 (Electronic)
ISSN-L
0942-2056
Statut éditorial
Publié
Date de publication
2011
Volume
19
Numéro
9
Pages
1473-1478
Langue
anglais
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Résumé
PURPOSE: We report a continuous series of periprosthetic femoral fractures after knee arthroplasty treated with a locking plate. We hypothesize that minimally invasive surgery and immediate weight-bearing improve functional recovery.
METHODS: From June 2002 to December 2008, 15 patients with 16 fractures were treated. Median age was 81 years. The autonomy level according to the mobility score of Parker and Palmer showed a median of 5 (0-9). Osteosynthesis was performed mainly through a minimally invasive approach using a locking compression plate. The rehabilitation protocol consisted of immediate mobilization and, whenever possible, immediate unrestricted weight-bearing.
RESULTS: Five patients died during follow-up, more than 1 year after osteosynthesis. Their results were included. Autonomy and mobility were preserved with a median postoperative score of 4 (0-9) according to Parker and Palmer. The consolidation rate was 93.8%, which was obtained within 10 weeks. There were no mechanical or infectious complications. Fourteen cases were treated with minimally invasive surgery without fracture exposition; the remaining 2 required a slightly more extended approach. Full weight-bearing occurred 10 times; 20-kg partial weight-bearing was advised twice; and on 4 occasions, no weight-bearing was allowed for 6 weeks.
CONCLUSION: Osteosynthesis with a minimally invasive bridge-plating technique is effective in the treatment of periprosthetic, distal femoral fractures without component loosening. Immediate full weight-bearing is possible if certain rules are respected. The surgical management presented herein is beneficial for these challenging fractures, and it may help reduce the complication rate and improve functional outcome.
Mots-clé
Aged, Aged, 80 and over, Arthroplasty, Replacement, Knee/adverse effects, Arthroplasty, Replacement, Knee/methods, Bone Plates, Cohort Studies, Female, Femoral Fractures/radiography, Femoral Fractures/surgery, Follow-Up Studies, Fracture Fixation, Internal/instrumentation, Fracture Fixation, Internal/methods, Fracture Healing/physiology, Humans, Male, Periprosthetic Fractures/radiography, Periprosthetic Fractures/surgery, Postoperative Complications/radiography, Postoperative Complications/surgery, Range of Motion, Articular/physiology, Recovery of Function, Retrospective Studies, Risk Assessment, Surgical Procedures, Minimally Invasive/methods, Time Factors, Treatment Outcome
Pubmed
Web of science
Création de la notice
23/09/2014 19:48
Dernière modification de la notice
20/08/2019 15:16
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