Early healing with locked condylar plating of periprosthetic fractures around the knee

Management of periprosthetic fractures around the knee is often difficult because of poor bone quality, comminution, and constraints imposed by the existing prosthesis. Locked condylar plates may provide more reliable fixation for these fractures than traditional methods of fixation. Eleven patients with periprosthetic fractures around the knee were treated with open reduction and internal fixation using a locked condylar plate. All 9 acute fractures and 1 of 2 periprosthetic nonunions healed at an average of 21 weeks, and no patient required additional surgery. Nine fractures healed in anatomical alignment, whereas 1 healed in 5°valgus. The remaining periprosthetic nonunion developed a persistent nonunion with subsequent hardware failure. The average range of motion was 4°to 92°. Locked plating systems are highly effective for the management of complex periprosthetic fractures around the knee. They result in reliable fracture healing and permit early motion in complex fractures.