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TKA Periprosthetic Fracture
Posted: Oct 14 2021 #(C101808)
B

Periprosthetic Femoral Shaft Fracture in 70M

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HPI

Immense pain in left thigh after stepping down from a step. Endorses history of remote trauma that occurred in the 1970's where he sustained a mid-shaft femur fracture. He was treated non-operatively at that time and had residual shortening of his left lower extremity. Patient also endorses status post bilateral TKA and had revision at the left TKA due to infection approximately 10 years ago.

PMH

Asthma Sleep Apnea Left femur fracture Knee osteoarthritis Prosthetic joint infection

PE

LLE: No open wounds. Deformity noted at the thigh. There is bruising present over the anterior thigh. Significant TTP. Compartments soft to palpation. Sensation intact to light touch grossly. DP and PT pulses palpable. Capillary refill time brisk. Motor intact to EHL, FHL, TA, GS. No pain with log rolling of hip.

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In addition to the plain film radiographs, would you obtain any additional imaging to guide management?
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Would you use a classification system to help guide treatment of this injury?
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How would you immobilize this injury initially?
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How would you manage this injury?
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How would you correct the deformity?
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P: 137575
If you choose operative management, what post-operative weight-bearing status would you assign the patient?
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P: 137576
PROCEDURE #1

ORIF L periprosthetic femur fracture

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