Supracondylar fracture of the femur after GUEPAR total knee arthroplasty. A new treatment method.

A 71-year-old woman incurred an unstable, comminuted supracondylar fracture of the femur above the tip of a GUEPAR prosthesis. The prosthesis was not loose. Immediate open reduction and internal fixation were performed using a segment cut from an intramedullary rod. This provided axial alignment and functioned as an internal stent with stable fixation of the fracture. Supplementary fixation with a plate and screws, cerclage wires, and an autogenous bone graft led to early mobilization, solid bony union, and an excellent functional result.