PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL

A. R. Hassan; K. Lee-A-Ping; J. Pegrum; A. Dodds

doi:10.1302/1358-992X.2022.7.007

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PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL

The British Association for Surgery of the Knee (BASK) May 2022 Meeting, Newport, Wales, 17–18 May 2022.

A. R. Hassan
K. Lee-A-Ping
J. Pegrum
A. Dodds

PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL

Hassan AR, Lee-A-Ping K, Pegrum J, Dodds A. PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL. Orthop Procs. 2022;104-B(SUPP_7):7-7. doi:10.1302/1358-992X.2022.7.007

Hassan, A. R., et al. “PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_7, 2022, pp. 7-7., https://doi.org/10.1302/1358-992X.2022.7.007

Hassan, A. R., Lee-A-Ping, K., Pegrum, J., & Dodds, A. (2022). PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL. Orthopaedic Proceedings, 104-B(SUPP_7), 7-7. https://doi.org/10.1302/1358-992X.2022.7.007

Hassan, A. R., Lee-A-Ping, K., Pegrum, J. and Dodds, A. (2022) “PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL.” Orthopaedic Proceedings, 104-B(SUPP_7), pp. 7-7. Available at: https://doi.org/10.1302/1358-992X.2022.7.007

Hassan, A. R., K. Lee-A-Ping, J. Pegrum, and A. Dodds. “PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL.” Orthopaedic Proceedings 104-B, no. SUPP_7 (2022): 7-7. https://doi.org/10.1302/1358-992X.2022.7.007

Hassan AR, Lee-A-Ping K, Pegrum J, Dodds A. PERIPROSTHETIC DISTAL FEMORAL FRACTURES: REVIEW OF SEVEN YEARS OF PRACTICE IN A DISTRICT GENERAL HOSPITAL. Orthop Procs. 2022 Jul 1;104-B(SUPP_7):7-7. https://doi.org/10.1302/1358-992X.2022.7.007

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Abstract

Introduction

Distal Femoral Fractures around a Total Knee Replacement have a reported incidence of 0.25–2.3% of primary TKRs. Literature suggests that these fractures have high complication rates such as non union and revision.

Methodology

A retrospective case note review was undertaken of all patients who sustained a distal femoral fracture around a TKR from April 2014-April 2021. Data parameters collected included patient demographics, classification of fracture, management, post op mobility, fracture union and mortality.

Results

52 distal femoral fractures were recorded, out of which 5 patients had bilateral fractures. The average age was 83.6 years (61–101). 41 fractures were managed operatively with 61% undergoing ORIF, 37% undergoing Distal Femoral Replacement & 2% undergoing a retrograde IM Nail. The median LOS was 22 days (11–85) for patients treated with DFR versus 10 (3–75) for those undergoing an ORIF. 60% of DFR patients were discharged home compared to 56% of those who underwent an ORIF. All the DFR patients were FWB post op compared to ORIF 24%.

Conclusion

Over a 7 year study period, 52 distal femoral fractures were reviewed. Despite FWB status post op, patients undergoing a DFR had a longer length of stay and less were discharged home compared to the ORIF group. Given the cost of a distal femoral replacement (£4485-6500) compared to £212-297 for a locking plate, in order to get patients FWB post operatively potentially dual plating (medial and lateral) may need to be considered if the fracture is amenable to improve stability & allow FWB.