{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T07:11:01Z","timestamp":1758265861779},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Treatment of distal femur fractures by long\u2010stemmed total knee arthroplasty (<jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>) is challenging, because of poor bone stock, decreased blood supply, history of multiple knee surgeries and an absence of standard treatment. Few published studies are available concerning this. The purpose of this study was to share surgical technique and better describe our patients' comorbidities, which add to the challenge of managing individuals with these fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between August 2008 and September 2013, seven patients presented to our level I trauma center with distal femoral fractures associated with long\u2010stemmed TKA implants. Their average age was 68.71 years (range, 52\u201381 years).The most common mechanism of injury was fall (five patients), followed by a traumatic fracture of the femur while walking (one patient), and being lifted out of bed (the one nonambulatory patient). This retrospective study reports a treatment protocol, including surgical technique, and short\u2010term outcome in seven patients in whom locking compression plates (<jats:styled-content style=\"fixed-case\">LCP<\/jats:styled-content>) were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six fractures were classified as Rorabeck type II, and one as type III. The average time to full\u2010weight\u2010bearing was 5.5 months. At this institution, good short\u2010term results have been achieved by using an <jats:styled-content style=\"fixed-case\">LCP<\/jats:styled-content> with screws placed proximal to the long\u2010stem and distal to the fracture. The six patients all achieved full\u2010weight\u2010bearing,taking an average of 5.5 months (range, 3\u20137 months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">LCP<\/jats:styled-content> is an effective form of management of distal femur fractures around long stem <jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>s. An individualized operative approach possibly incorporating bone\u2010graft substitutes, cerclage wire and a post\u2010operative bone stimulator is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12117","type":"journal-article","created":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T12:26:12Z","timestamp":1409574372000},"page":"217-222","source":"Crossref","is-referenced-by-count":6,"title":["Challenge of Managing Distal Femur Fractures with Long\u2010stemmed Total Knee Implants"],"prefix":"10.1111","volume":"6","author":[{"given":"Nabil A","family":"Ebraheim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Toledo Medical Center  Toledo Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Toledo Medical Center  Toledo Ohio 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