Fixation of the distal portion of the femur in patients with total knee arthroplasties can be challenging. Locking plates have emerged as a promising treatment. Twenty-seven patients with periprosthetic distal femur fractures after total knee arthroplasties were treated using a contralateral reverse distal femoral locking plate. The average time for union and weight-bearing was 4.5 ± 2.7 months. The union rate was 89%. Thirty-seven percent experienced complications, with 2 delayed unions (7.4%), 1 nonunion (3.7%), and 7 fixation failures (26%). Alteration in blood supply and biomechanics as well as poor existing bone quality and minimal distal femur bone stock may contribute to treatment difficulties.
Published by Elsevier Inc.