Rorabeck and Taylor developed an algorithm for treating a patient with a femoral supracondylar periprosthetic fracture proximal to a knee arthroplasty. The authors are from the University of Western Ontario in Canada.
Parameters:
(1) fracture type (classification of Lewis and Rorabeck, previous section)
(2) bone quality
Fracture Type |
Bone Quality |
Preferred Therapy |
Secondary Therapy |
Type I (stable and undisplaced) |
NA |
closed treatment with brace |
ORIF with IM rod, plate/screws, external fixation |
Type II (stable and displaced) |
NA |
ORIF with IM rod, plate/screws, external fixation |
closed reduction with brace |
Type III (unstable and undisplaced) |
good |
stemmed revision with ORIF |
NA |
Type III (unstable and undisplaced) |
poor |
stemmed revision with or without ORIF, plus bone graft |
closed reduction with brace |
Type III (unstable and displaced) |
good |
stemmed revision with or without ORIF, plus bone graft |
NA |
Type III (unstable and displaced) |
poor |
stemmed revision OR allograft composite OR custom TKA |
NA |
where:
• ORIF = open reduction with internal fixation
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general