
What Is the Likelihood of Union After Coronal Limb Realignment Using Revision Osteosynthesis and Concurrent TKA in Patients with Advanced Arthritis and Loss of Fixation After Distal Metaphyseal Femur Fractures?
Author(s) -
Ashok S. Gavaskar,
Parthasarathy Srinivasan,
Rufus V Raj,
Balamurugan Jayakumar,
Kirubakaran Pattabiraman
Publication year - 2021
Publication title -
clinical orthopaedics and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.178
H-Index - 204
eISSN - 1528-1132
pISSN - 0009-921X
DOI - 10.1097/corr.0000000000001652
Subject(s) - medicine , coronal plane , nonunion , femur , deformity , surgery , fixation (population genetics) , arthritis , anatomy , population , environmental health , immunology
Metaphyseal fracture healing in the distal femur requires a stable biomechanical environment. The presence of arthritis-induced coronal-plane knee deformities can cause deviation of the mechanical axis, which results in asymmetric loading and increased bending forces in fractures of the distal femur metaphysis. This predisposes patients to nonunions or loss of fixation. Concurrent TKA during revision osteosynthesis might facilitate fracture healing, owing to its ability to correct coronal alignment, thereby restoring normal loading patterns at the fracture site, but to our knowledge, this has not been studied.