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<p>Periprosthetic femoral fractures represent a&#xa0;severe injury with perioperative risks comparable to proximal femoral fractures. The choice of treatment for periprosthetic fractures of the distal femur is primarily determined by the stability of the femoral component of the arthroplasty, fracture morphology, bone quality, and patient-specific factors. In the presence of a&#xa0;stable arthroplasty, osteosynthetic techniques are indicated. Single lateral plate fixation is suitable for uncomplicated fracture patterns with a&#xa0;distal–lateral fracture extension. Multifragmentary fractures benefit from double-plate constructs or combined nail–plate fixation. These techniques provide increased stability and result in lower failure rates. In case of an&#xa0;instable femoral component, revision arthroplasty is mandatory. Patients with nonreconstructable bone stock may benefit from distal femoral replacement, allowing immediate full weight bearing. However, there is a&#xa0;higher likelihood of complications. Overall, treatment decisions should be patient-specific focusing on the stability of the femoral component and the fracture morphology.</p>

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Versorgung periprothetischer Frakturen: distales Femur

  • 期刊论文

  • 发表日期：

    2026年1月16日

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  • Steffen Schröter,
  • Marc-Daniel Ahrend

摘要

Periprosthetic femoral fractures represent a severe injury with perioperative risks comparable to proximal femoral fractures. The choice of treatment for periprosthetic fractures of the distal femur is primarily determined by the stability of the femoral component of the arthroplasty, fracture morphology, bone quality, and patient-specific factors. In the presence of a stable arthroplasty, osteosynthetic techniques are indicated. Single lateral plate fixation is suitable for uncomplicated fracture patterns with a distal–lateral fracture extension. Multifragmentary fractures benefit from double-plate constructs or combined nail–plate fixation. These techniques provide increased stability and result in lower failure rates. In case of an instable femoral component, revision arthroplasty is mandatory. Patients with nonreconstructable bone stock may benefit from distal femoral replacement, allowing immediate full weight bearing. However, there is a higher likelihood of complications. Overall, treatment decisions should be patient-specific focusing on the stability of the femoral component and the fracture morphology.