KẾT QUẢ PHẪU THUẬT GÃY XƯƠNG ĐÙI QUANH KHỚP GỐI NHÂN TẠO: BÁO CÁO CA LÂM SÀNG VÀ NHÌN LẠI Y VĂN

Abstract

Objective: Describe the clinical and paraclinical features and the surgical outcomes of a periprosthetic femoral fracture around a total knee arthroplasty (TKA). Methods: A case report. Results: Periprosthetic distal femur fractures around TKA are uncommon but challenging due to post-arthroplasty bone quality reduction and the need to preserve the prosthesis. A 70-year-old woman with a history of left TKA 1 year prior presented with left knee pain and inability to bear weight after a low-energy domestic fall. Radiographs demonstrated a distal femur fracture proximal to a well-fixed TKA. Open reduction and internal fixation were performed via a lateral approach using a lateral distal femoral locking plate and screws. Anatomic reduction and stable fixation were achieved without compromising the prosthesis. The patient commenced partial weight-bearing at 6 weeks and progressed to full weight-bearing at 12 weeks. By month 4, she ambulated pain-free; at month 9, radiographs confirmed complete union with no evidence of prosthetic loosening. This case underscores the successful use of locking plate fixation for periprosthetic distal femur fractures and highlights the importance of choosing fixation rather than distal femoral replacement when bone stock is adequate and the TKA is stable. Conclusion: Locking-plate fixation permits reliable fracture union while preserving the prosthesis and minimizing surgical invasiveness. This approach is particularly suitable for patients with sufficient distal femoral bone stock and a well-fixed TKA.