• Medicina · Aug 2022

    Case Reports

    Successful Plate Fixation with Long Intramedullary Fibula Bone Graft for Periprosthetic Femur Fracture: A Case Report.

    • Kuei-Lin Yeh, Chen-Kun Liaw, Chiou-Shann Fuh, Chu-Song Chen, Chen-Hao Chiang, and Kao-Shang Shih.
    • Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Rd., East District, Chia-Yi City 600566, Taiwan.
    • Medicina (Kaunas). 2022 Aug 24; 58 (9).

    AbstractBackground and objectives: Treatment of a displaced or comminuted periprosthetic distal femur fracture is challenging, especially in patients with osteoporosis. In this case report, we shared our successful surgical experience of using a long intramedullary fibula bone graft in a plate fixation surgery for a periprosthetic distal femur fracture in an extremely elderly patient with osteoporosis. Case report: A 95-year-old woman with severe osteoporosis (bone mineral density level: -3.0) presented with right knee pain and deformity after a fall, and a right periprosthetic distal femur fracture was identified. The patient underwent an open reduction and an internal plate fixation surgery with the application of a long intramedullary fibular bone graft. Due to a solid fixation, immediate weight-bearing was allowed after the surgery. She could walk independently without any valgus or varus malalignment or shortening 3 months after the surgery. A solid union was achieved 4 months postoperatively. Conclusions: We present a case wherein a long intramedullary allogenous fibula strut bone graft was used successfully to treat a right periprosthetic femur fracture in an extremely elderly patient. A long allogenous fibula bone graft can act not only as a firm structure for bridging the bone defect but also as a guide for precise component alignment. We believe this treatment option for periprosthetic fractures is beneficial for achieving biological and mechanical stability and facilitates early mobilization and weight-bearing for the patient.

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