Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail

Moon-Jib Yoo; You-Jin Kim; Jin-Won Lee

doi:10.12671/jkfs.2008.21.1.19

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Yoo, Kim, and Lee: Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail

Original Article

Journal of the Korean Fracture Society 2008; 21(1): 19-23.

Published online: 31 January 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.1.19

Retrograde Nailing for Supracondylar Fracture after Total Knee Replacement: The Compatibility of Femoral Implant with Supracondylar Nail

Moon-Jib Yoo, M.D., You-Jin Kim, M.D.^*, Jin-Won Lee, M.D.

Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea.

^*Department of Orthopaedic Surgery, National Police Hospital, Seoul, Korea.

Address reprint requests to: You-Jin Kim, M.D. Department of Orthopaedic Surgery, National Police Hospital, 58, Garakbon-dong, Songpa-gu, Seoul 138-708, Korea. Tel: 82-2-3400-1243, Fax: 82-2-449-2129, kyj1009@hanmir.com

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Retrograde intrameullary nail is one of the treatment of periprosthetic supracondylar femoral fracture after total knee replacement (TKR), but all TKRs will not permit to insert a supracondylar nail. Therefore, we have investigated the compatibility of the TKRs with supracondylar nail.

Materials and Methods

Using trial femoral component of the 5 used TKRs in Korea and saw bone model, we checked their compatibility and measured the dimensions of the intercondylar notches in both cruciate retaining (CR) and posterior stabilized (PS) type.

Results

Although most CR prostheses had an intercondylar notch large enough to accept a supracondylar nail, in some case, this was not possible due to the notch being situated too far posteriorly. The position of the intercondylar notch is also important factor in the PS prostheses.

Conclusion

The notch position, rather than the notch size, was the most important factor in determining nail compatibility with femoral stem.

Keywords: Total knee replacement, Periprosthetic fracture, Retrograde intrameullary nail

Figures and Tables

Fig. 1

Anteroposterior (A) and lateral (B) view of the photograph shows the nail's compatibility with femoral component in saw bone model.

Fig. 2

The femoral component is not compatible with the nail, despite the notch being large enough, as it is situated too posteriorly.

Table 1

The intercondylar notch dimensions of the 5 TKRA and their compatibility with supracondylar nails

^*N/A: Not available.

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