Osteosynthese distales Femur

Periprothetische distale Femurfrakturen stellen uns vor Herausforderungen in Bezug auf die Versorgungsstrategien. Diese reichen von der Osteosynthese bis zur Revisionsprothese. Eine breite orthopädisch-unfallchirurgische Ausbildung ist die Basis für die bestmögliche Versorgung, die präoperative Planung/Analyse (Frakturtyp, Prothesendesign, Bone Stock) und für den Erfolg entscheidend. Das Ziel sollte die rasche Remobilisation unter Vollbelastung sein.

Abstract

Periprosthetic distal femur fractures (PDFF) after total knee arthroplasty are increasingly encountered due to aging populations and comorbidities such as osteoporosis and falls in the elderly. Conservative management plays only a minor role, while treatment strategies focus on revision arthroplasty or osteosynthesis. Intramedullary nailing and plate fixation, including dual-plate constructs, represent the main options, each influenced by prosthesis type, fracture morphology, and bone stock.
Retrograde nailing provides a minimally invasive option but is limited by implant design, whereas plating offers greater flexibility and stability, particularly in complex fracture patterns. Dual plating may enable earlier full weight-bearing and reduce mechanical complications. Preoperative assessment of prosthesis type, bone quality, and patient comorbidities is crucial.
Management must be individualized, as no universal algorithm exists. The primary goals are stable fixation, early mobilization, and restoration of pre-injury functional capacity to minimize morbidity and mortality.

Schlüsselwörter

periprothetische Frakturen - Revisionsendoprothese - Knietotalendoprothese - distales Femur - Dual Plating

Keywords

periprosthetic fractures - revision arthroplasty - total knee arthroplasty (TKA) - distal femur - dual plating

Publikationsverlauf

Artikel online veröffentlicht:
07. Oktober 2025

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