PMC8612792_01
Preoperative A-P (a) and lateral (b) radiographs showing a complex left supracondylar distal femoral fracture adjacent to a total knee arthroplasty.
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fig1
Plain radiographs were done and showed a supracondylar displaced periprosthetic fracture of the left distal femur (Figure 1).
Postoperative lateral (a) and A-P (b, c) radiographs done in the OR, showing reduction of fracture status post management with ORIF and lateral plate-and-screw fixation.
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fig2
The patient underwent surgical open reduction and internal fixation (ORIF) with bone graft and lateral plate-and-screw (Figure 2).
Postoperative follow-up A-P radiographs done one month postoperatively showing reduced fracture and beginning of callus formation in the distal femoral region.
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fig3
One month postoperatively, a follow-up radiograph showed fracture reduction with start of callus formation (Figure 3).
Postoperative follow-up A-P and lateral radiographs done two months postoperatively showing nonunion with severe comminution in the distal femoral region which is also associated with low bone stock.
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fig4
Postoperative follow-up AP and lateral radiographs done nine months after the surgery still showing nonunion, comminution, and low bone stock (yellow arrows).
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Postoperative follow-up with 3D reconstruction done one year postoperatively showing fracture nonunion (yellow circle), malalignment, and plate breakage (yellow arrow).
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Postoperative follow-up radiographs done one month after revision surgery showing satisfactory alignment.
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Postoperative follow-up AP radiograph of both knees nine months after revision surgery showing improvement in healing and satisfactory alignment.
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Postoperative radiographs two months after hardware removal showing complete healing of the fracture with satisfactory alignment.
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fig9
Cultures obtained two months later revealed negative tissue and serum results, and plain radiographs (Figure 9) showed complete healing of the fracture with a satisfactory alignment.