Muhammed Fatih SERTTAŞ, Buğra Han ERYILMAZ, Ümit GÖK, Fevzi SAĞLAM
Sakarya Tıp Dergisi - 2026;16(1):19-26
Objective: This study aimed to compare retrograde intramedullary nailing (RIMN) and femoral locked plating (FLP) in the management of periprosthetic supracondylar femur fractures (PSFF) following total knee arthroplasty (TKA), focusing on fracture healing, blood loss, functional outcomes, and complication rates. Methods: Thirty-one patients surgically treated for PSFF between 2015 and 2021 were retrospectively analyzed. According to the fixation method, patients were divided into two groups: FLP (n=19) and RIMN (n=12). Group allocation was based on fracture pattern, distal fragment length, and prosthesis compatibility. Fractures were classified according to the Su system. Operative parameters, intraoperative blood loss, transfusion requirement, union time, complications, and functional outcomes (Knee Society Score, KSS) were evaluated. Statistical analysis was performed using SPSS 23.0, with a significance level of p<0.05. Results: No significant difference was found between groups in terms of demographics, fracture type, or complication rate (p>0.05). The RIMN group showed significantly lower intraoperative blood loss and transfusion requirements (p<0.001 and p=0.016, respectively). KSS and KSS-functional scores were significantly higher in the RIMN group (p=0.022 and p=0.028). There was no significant difference in union time between the two fixation methods. Conclusions: Both fixation methods are effective for PSFF treatment; however, RIMN provides advantages in terms of reduced blood loss, lower transfusion needs, and superior postoperative functional outcomes. Surgical method selection should be individualized according to bone quality, fracture morphology, and prosthesis compatibility.
