슬관절 전 치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 내고정술

Abstract

Purpose: We evaluated the radiologic and clinical results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, Included Lewis-Rorabeck type II, 13 cases of periprostheic femur fracture after TKA were available after a minimum follow up of 12 months. Osteosynthesis was performed using dual plate fixation including mini-open medial plate and additional minimal invasive lateral plate technique. Inclusion criteria were Su's type III periprosthetic femur fracture, severe communited supracondylar fracture, stem in medullary canal. The mean age was 72(65-82) years and 11 cases were women. 9 cases injured due to slip down and 4 cases were motor vehicle. The causes of primary TKA were osteoarthritis except for 1 case of rheumatoid arthritis. Mean BMD(bone mineral density) was -3.2(-1.7--4.4). Mean time from primary TKA to periprosthetic fractures were 28(1-108) months. Mean follow up period were 23(12-65) months. The average union time, radiologic alignment, range of motion(ROM) of knee, complications and Hospital for Special Surgery Knee Score(HSS) at last follow up were evaluated. Results: The mean union time were 15(7-24) weeks. 2 cases were delayed bone and nonunion was occurred in 1 case. Mean aligment in anterior-posterior view was 1.7(-1.2-4.9)˚varus angulation and lateral view was 3(0-4.9)˚ anterior angulation, mean knee ROM was 90(35-120)˚ and HSS score was 85(70-95) points at last follow up. Conclusion: Dual plate fixation for difficult periprostheic femur fracture after TKA was obtained good clinical and radiologic result.