PMC5451780_01
Presenting knee injury X-rays. Note the severe comminution of the metaphyseal area, including the medial wall of the distal femur. Radiologically, the femoral component seemed to be fixed.
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fig1
There was no sign of loosening of the femoral component (Figure 1).
Immediate postoperative X-rays showing good reduction of the fracture, anatomic alignment of the articular surface, and rigid fixation. (a) Note the nonvascularized fibular strut graft. The larger piece was used to bridge the metaphyseal defect and the small piece to replace the medial wall of the distal femur. (b) The alignment of the knee joint was anatomically restored.
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fig2
Finally the periprosthetic fracture was fixed with an anatomic locking plate (GMReis, Campinas, Brazil) applied on the lateral surface of the distal femur (Figure 2).
Final follow-up radiographs showing osseointegration of the fibular graft with definite bridging of the distal metaphyseal femur defect.
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fig3
Last X-rays demonstrated complete healing of the fracture with osseointegration of the fibular strut graft (Figure 3).
Patient had no pain involving the donor leg at the time of the most recent follow-up examination. Note the large resection of the fibular shaft.
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fig4
No pain involving the donor graft site was reported at the time of the most recent follow-up examination (Figure 4).