Felix et al developed an algorithm for the management of a tibial fracture adjacent to a knee prosthesis. The authors are from the Mayo Clinic.
Parameters:
(1) occurrence - intraoperative vs postoperative fracture
(2) type of fracture (Mayo classification)
(3) status
(4) fracture displaced/nondisplaced (if postoperative, Type II or III, secure prosthesis)
Postoperative Fracture
Type |
Status |
Displaced |
Management |
I |
secure |
NA |
brace, cast, protected weightbearing |
I |
loose |
NA |
revision arthroplasty |
II |
secure |
nondisplaced |
brace, cast, protected weightbearing |
II |
secure |
displaced |
closed reduction and cast, or ORIF |
II |
loose |
NA |
revision arthroplasty |
III |
secure |
nondisplaced |
brace, cast, protected weightbearing |
III |
secure |
displaced |
closed reduction and cast, or ORIF |
III |
loose |
NA |
fracture treatment and revision arthroplasty |
Intraoperative Fracture
Type |
Status |
Management |
I |
stable |
brace, protected weightbearing |
I |
unstable |
screw fixation, stem bypass |
II |
stable |
brace, protected weightbearing |
II |
unstable |
bone graft, stem bypass |
III |
stable |
immobile, protected weightbearing |
III |
unstable |
closed reduction and cast, or ORIF |
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
ICD-10: ,