Modified fixation for periprosthetic supracondylar femur fractures: Two case reports and review of the literature

Figure 1 Preoperative images of case 1. A: Anteroposterior radiographs of the right distal femur at the time of presentation showing the supracondylar femoral fracture above total knee arthroplasty which was non-comminuted and oblique; B: Lateral radiograph of the right periprosthetic supracondylar femoral fracture.

Figure 2 Preoperative images of case 2. A: Plain radiographs of the left distal femur at the time of presentation showing the supracondylar femoral fracture just above total knee arthroplasty, which was non-comminuted and transverse; B: Sagittal computed tomography image of the left periprosthetic supracondylar femoral fracture.

Figure 3 Implant of modified nail plate combination. Image of implant showing a specially designed periprosthetic locking plate, a retrograde intramedullary nail, an intramedullary targeting arm, locking screw guide and k wires.

Figure 4 Postoperative and follow-up images of case 1. A: Anteroposterior and lateral X-ray showing good reduction of periprosthetic supracondylar femoral fracture through modified nail plate combination; B: Anteroposterior and lateral X-ray taken 6 mo later showing evidence of union.

Figure 5 Postoperative and follow-up images of case 2. A: Anteroposterior and lateral X-ray showing good reduction of periprosthetic supracondylar femoral fracture through modified nail plate combination; B: Anteroposterior and lateral X-ray taken 6 mo later showing evidence of union.