Triple fracture during rehabilitation after revision total knee arthroplasty.

PURPOSE: The incidence of periprosthetic fractures after knee-joint implant revisions is increasing in prevalence. We present a method of treatment for a patient who sustained a triple fracture--a periprosthetic femur fracture, a patella fracture, and a tibial shaft fracture.

METHODS

The femoral fracture was treated with a specially designed intramedullary nail, the patella fracture with a figure-of-eight suture, and the tibial shaft fracture by a minimal-invasive plate osteosynthesis using a percutaneous plating technique.

RESULTS

Osseous consolidation was confirmed, and the patient presented a satisfying range of movement under full-weight-bearing conditions after mobilisation.

CONCLUSIONS

Simultaneous multiple periprosthetic fractures are a special challenge, and in situ coupling of the endoprosthesis with a slotted hollow nail presents a valuable option for the treatment.

LEVEL OF EVIDENCE: Level V, Expert opinion.