{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T04:30:26Z","timestamp":1683174626698},"reference-count":18,"publisher":"SLACK, Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>\n            Distal femur fractures above a total knee arthroplasty (TKA) are challenging. These fractures can be fixed with a retrograde intramedullary nail (rIMN), but the design of the femoral component of the TKA influences the starting point for an rIMN. We performed a biomechanical study to evaluate how different TKA components influence the starting point for an rIMN and how that can lead to a deformity in the sagittal plane. We simulated a distal femur fracture with three different arthroplasty components. We used three different implants to simulate fracture reduction and measured the resultant sagittal plane deformity. Low and moderate femoral component ratio (FCR) design components were able to maintain fracture alignment within 5\u00b0 of anatomic. High FCR component (more posterior starting point) sagittal plane deformities of up to 15\u00b0 were observed with both the straight and medium Herzog bend nails, which was statistically significant (\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). Use of a high Herzog bend nail decreased the deformity by an average of 6\u00b0, which was statistically significant (\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). There is variability in how the TKA design affects the starting point and thus the sagittal plane alignment after fixation. This study helps quantify the effect of arthroplasty component design on fracture alignment. [\n            <jats:italic>Orthopedics<\/jats:italic>\n            . 2023;46(1):35\u201338.]\n          <\/jats:p>","DOI":"10.3928\/01477447-20221003-03","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T20:04:24Z","timestamp":1665173064000},"page":"35-38","source":"Crossref","is-referenced-by-count":0,"title":["\u201cNailable\u201d Does Not Always Mean Reducible in Distal Femur Fractures: Arthroplasty Component and Nail Design Matter"],"prefix":"10.3928","volume":"46","author":[{"given":"Benjamin M.","family":"Braun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy A.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric F.","family":"Swart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01617"},{"key":"e_1_3_1_3_2","first-page":"251","article-title":"Peri-prosthetic hip and knee fractures: the scope of the problem","volume":"47","author":"Younger AS","year":"1998","unstructured":"Younger AS, Dunwoody J, Duncan CP. 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Stabilization of distal femur fractures with intramedullary nails and locking plates: differences in callus formation. Iowa Orthop J. 2010;30:61\u201368. 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