Interprosthetic femur fractures, occurring between an ipsilateral Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA), present unique challenges due to the patient having multiple prosthetic components and, as is commonly seen in elderly patients, poor bone quality. Traditional treatments, such as isolated nailing or plating alone, typically do not support early weight-bearing, which is crucial for active patients seeking rapid recovery. This case report details the management of a highly comminuted interprosthetic femur fracture in an osteopenic 80-year-old active female patient using a combination of nailing and plating (NP fixation).
The patient’s primary goal was to quickly resume an active lifestyle post-surgery, which would not be possible utilizing either plating or nailing alone. Therefore, NP fixation was chosen for treatment and the procedure involved using a lateral femoral locking plate in combination with an intramedullary nail, creating a stable construct.
Postoperatively, the patient achieved immediate knee stability and full range of motion without complications. At two weeks, she showed excellent fracture alignment and mobility. Additionally, she was allowed weight bearing as tolerated, and by twelve weeks, she resumed normal activities, discontinuing physical therapy.
This case demonstrates the potential benefits, particularly in elderly patients with high functional demands, of NP fixation in comparison to utilizing either intramedullary nailing or plating alone for complex interprosthetic femur fractures. The approach provided robust stabilization and enabled near immediate weight-bearing, illustrating improvement over the more traditional methods. Further research is needed to validate NP fixation’s effectiveness across a broader patient population.
The patient’s primary goal was to quickly resume an active lifestyle post-surgery, which would not be possible utilizing either plating or nailing alone. Therefore, NP fixation was chosen for treatment and the procedure involved using a lateral femoral locking plate in combination with an intramedullary nail, creating a stable construct.
Postoperatively, the patient achieved immediate knee stability and full range of motion without complications. At two weeks, she showed excellent fracture alignment and mobility. Additionally, she was allowed weight bearing as tolerated, and by twelve weeks, she resumed normal activities, discontinuing physical therapy.
This case demonstrates the potential benefits, particularly in elderly patients with high functional demands, of NP fixation in comparison to utilizing either intramedullary nailing or plating alone for complex interprosthetic femur fractures. The approach provided robust stabilization and enabled near immediate weight-bearing, illustrating improvement over the more traditional methods. Further research is needed to validate NP fixation’s effectiveness across a broader patient population.