An alternative treatment for osteoporotic Su Type III periprosthetic supracondylar femur fractures: Double locking plate Şxation

Abstract

Introduction: Patients with Su Type III fractures based on total knee arthroplasty (TKA) constitute apatient group with problematic treatment and management. Although it has difŞculties, open reductionand internalŞxation is one of the treatment options.Method: A retrospective evaluation was made of 22 patients surgically treated in our clinic with doublelocking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. Thepatients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS),WOMAC and radiological evaluations.Results: The mean follow-up period of the patients was 68.6± 15.5 months, with pain-free weightbearing determined at 4.9± 1.1 months and mean radiological union at 18.5 ± 4.3 weeks. Revision wasrequired because of non-union in 2 (9.09%) cases. The postoperative KSS value was 81.8± 7.8, theWOMAC value was 78.1± 5.3 and the T-score was 3.3 ± 0.3. At the Şnal follow-up examination, acorrection loss (4.9± 1.5) was determined in the mean knee valgus angle according to the mechanicalaxis, which was statistically signiŞcant but remained within the physiological limits (p ¼ 0.21).Conclusion: In addition to providing the advantages of rigidŞxation together with early and effectiverehabilitation, satisfactory clinical and radiological results were obtained with the application of doublelocking plate and screw in the treatment of periprosthetic femoral fractures based on TKA, withosteoporosis.Level of evidence: Level IV, Therapeutic study.