Nail–Plate Constructs for Periprosthetic Distal Femur Fractures

Abstract

Over the past several years, the nail–plate construct (NPC) has emerged as a novel construct for the treatment of challenging distal femoral periprosthetic fractures. This construct, which uses a combination of the two primary treatment methods—lateral locked plating and retrograde intramedullary nailing, creates hybrid stabilization and allows the potential for early mobilization. This article will give the rationale for the use of the NPC as well as a review of the current published literature reviewing its use.

Keywords

distal femur periprosthetic fracture - nail–plate construct - fracture nonunion - internal fixation

• References

• 1 Della Rocca GJ, Leung KS, Pape HC. Periprosthetic fractures: epidemiology and future projections. J Orthop Trauma 2011; 25 (Suppl. 02) S66-S70
• 2 Sun ZH, Liu YJ, Li H. Femoral stress and strain changes post-hip, -knee and -ipsilateral hip/knee arthroplasties: a finite element analysis. Orthop Surg 2014; 6 (02) 137-144
• 3 Platzer P, Schuster R, Aldrian S. , et al. Management and outcome of periprosthetic fractures after total knee arthroplasty. J Trauma 2010; 68 (06) 1464-1470
• 4 Ristevski B, Nauth A, Williams DS. , et al. Systematic review of the treatment of periprosthetic distal femur fractures. J Orthop Trauma 2014; 28 (05) 307-312
• 5 Ricci WM. Periprosthetic femur fractures. J Orthop Trauma 2015; 29 (03) 130-137
• 6 https://www.clinicaltrials.gov/ct2/show/NCT01973712?cond=periprosthetic+femur&rank=3
• 7 Salas C, Mercer D, DeCoster TA, Reda Taha MM. Experimental and probabilistic analysis of distal femoral periprosthetic fracture: a comparison of locking plate and intramedullary nail fixation. Part B: probabilistic investigation. Comput Methods Biomech Biomed Engin 2011; 14 (02) 175-182
• 8 Chen SH, Chiang MC, Hung CH, Lin SC, Chang HW. Finite element comparison of retrograde intramedullary nailing and locking plate fixation with/without an intramedullary allograft for distal femur fracture following total knee arthroplasty. Knee 2014; 21 (01) 224-231
• 9 Birjandinejad A, Ebrahimzadeh MH, Ahmadzadeh-Chabock H. Augmentation plate fixation for the treatment of femoral and tibial nonunion after intramedullary nailing. Orthopedics 2009; 32 (06) 409
• 10 Liporace FA, Yoon RS. Nail plate combination technique for native and periprosthetic distal femur fractures. J Orthop Trauma 2019; 33 (02) e64-e68
• 11 Attum B, Douleh D, Whiting PS. , et al. Outcomes of distal femur nonunions treated with a combination nail/plate construct and autogenous bone grafting. J Orthop Trauma 2017; 31 (09) e301-e304
• 12 Kanabur P, Sandilands SM, Whitmer KK, Owen TM, Coniglione FM, Shuler TE. Nail and locking plate for periprosthetic fractures. J Orthop Trauma 2017; 31 (12) e425-e431