1. Clinical differences between periprosthetic and native distal femur fractures: a comparative observational study.
- Author
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Kong, Shana, Tse, Shannon, Saade, Aziz, Bautista, Barry, Haffner, Max, and Saiz, Augustine
- Subjects
Humans ,Female ,Male ,Retrospective Studies ,Femoral Fractures ,Aged ,Middle Aged ,Periprosthetic Fractures ,Fracture Fixation ,Intramedullary ,Aged ,80 and over ,Arthroplasty ,Replacement ,Knee ,Length of Stay ,Treatment Outcome ,Adult ,Cohort Studies ,Femoral Fractures ,Distal - Abstract
INTRODUCTION: The incidence of periprosthetic distal femur fractures (PDFF) is increasing as the number of total knee replacements becomes more common. This study compared the demographics, fracture characteristics, treatment, and outcomes of periprosthetic versus native distal femur fractures (NDFF). MATERIALS AND METHODS: This was a retrospective cohort study of patients ≥ 18 who underwent surgical fixation of NDFF or PDFF from 2012 to 2020 at a level-1 trauma center. The main variables collected included demographics, AO/OTA fracture classification, fixation construct, concomitant fractures, polytrauma rates, bone density, and reduction quality. Primary outcomes were unexpected return to the operating room (UROR), hospital length of stay, and quality of reduction. T-tests, Fishers exact tests, and multivariate analyses were used for statistical analysis. RESULTS: 209 patients were identified, including 70 PDFF and 139 NDFF. PDFF patients were elderly females (81%) with isolated (80%) and comminuted (85%) 33 A.3 (71%) fractures. NDFF patients included 53% females, were commonly middle-aged, and displayed comminuted (92%) 33 C.2 fractures. 48% of NDFF patients had concomitant fractures. Intramedullary nailing was the primary fixation for both groups, followed by nail-plate combination (37%) for PDFF and lateral locking plates (21%) for NDFF. NDFF patients experienced significantly longer hospital stays, higher UROR rates, and worse quality of reduction (p
- Published
- 2024