ORTHO
BULLETS
Free CME
Join now
Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

TKA Periprosthetic Fracture
Posted: Oct 28 2022 #(C102094)
A

TKA Periprosthetic Fracture in 75M

;
TKA Periprosthetic Fracture in 75M

HPI

A 75 year-old male presents after sustaining a fall due to a slip on the wet floors of a grocery store. Prior to the fall, the patient had a well-functioning TKA done in 2015. The implant is an open box Stelkast. The patient is moderately active. He only complains of isolated right knee pain currently.

PMH

None

PE

Focused examination of the right knee demonstrates that the patient is unable to ambulate. Hip ROM is non-painful. He has sustained no other injuries and his skin is intact. Patient is neurovascularly intact.

Poll
1 of 1
1. In addition to the AP + Lat radiographs of the femur (includes hip and knee joint), would you obtain any additional imaging to guide management?
No - current radiographs are sufficient
27%
223/814
    • Yes - addition radiographs (aXR)
    2%
    23/814
    • Yes - CT
    62%
    511/814
    • Yes - MRI
    0%
    8/814
    • Yes - aXR + CT
    3%
    25/814
    • Yes - aXR + MRI
    0%
    1/814
    • Yes - CT + MRI
    0%
    6/814
    • Yes - aXR + CT + MRI
    0%
    2/814
    • Outside my area of expertise - best if I don't vote
    1%
    15/814
    • PROCEDURE #1

    ORIF RIGHT FEMUR

    Intra-procedure P1
    icon
    OUTCOMES
    Post-procedure P1
    POLL#
    Surgeon's Choices
    1
    In addition to the AP + Lat radiographs of the femur (includes hip and knee joint), would you obtain any additional imaging to guide management?
    No - current radiographs are sufficient
    2
    How would you manage this injury?
    Operative
    3
    If you choose Operative management, what treatment would you perform?
    ORIF with Plate(s) Alone
    4
    If you choose ORIF with Plate(s) Alone, which plate construct would you use?
    Lateral plate fixation Alone
    5
    If you choose ORIF Alone with Lateral plate fixation Alone, what Approach would you use?
    Lateral - Submuscular plating (MIPO)
    6
    If you chose ORIF with Lateral plate fixation Alone, what type of plate would you use?
    Locking plate - Distal femoral locking
    7
    If you choose ORIF with Plate + IMN, what post-operative weight-bearing status would you assign the patient?
    Weight-bearing as tolerated (WBAT)
    8
    If you choose ORIF Alone with lateral plate and obtained the construct shown below, what DVT prophylaxis would you prescribe?
    Aspirin
    9
    If you choose ORIF Alone with Lateral plate fixation and obtained the construct below, and the patient had delayed union seen on radiographs, what time point would you declare nonunion?
    6 months
    All Videos (4) Podcasts (0)
    Sort by
    EF
    L1\L2 Evidence
    Date
    if (User.IsAuthenticated()) { }