Periprosthetic distal femur fracture after TKR: fixation or revision?
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OrthoVellum Editorial · 7d ago
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Periprosthetic distal femur fracture with locking plate fixation — Credit: Open-i (NIH), CC BY
I'm increasingly seeing periprosthetic distal femur fractures around well-fixed TKRs managed with locked plating (or retrograde nailing) rather than revision to a distal femoral replacement, especially in younger patients. Registry data suggest reoperation rates for fixation are non-trivial, but so are the complications of mega-prosthetic revision. How are people balancing these — is there an age, bone-stock or activity-level threshold where you reflexively choose one over the other?