Periprosthetic Distal Femur Fractures: A Single-Center Retrospective Epidemiological Analysis
DOI:
https://doi.org/10.14744/ajh.86Keywords:
distal femur fracture, periprosthetic fracture, total knee arthroplasty, epidemiology, AO/OTA classification, Rorabeck classification, Vancouver classificationAbstract
Background and Aims: Distal femur fractures (DFFs) are relatively rare but clinically significant injuries associated with high morbidity and mortality. With the rising prevalence of total knee arthroplasty (TKA), the proportion of periprosthetic distal femur fractures (PPDFFs) has been increasing. The incidence, classification, and clinical characteristics of DFFs, with a particular focus on PPDFFs, were aimed to be evaluated in this study.
Methods: Patients admitted to our tertiary care trauma center between January 2020 and 2025 with a diagnosis of distal femur fracture were included in this retrospective descriptive study. Demographic data, mechanism of injury, fracture classification, treatment preference, surgical approach, recorded complications, and comorbidities were analyzed.
Results: A total of 56 patients were evaluated, including 46 (82.1%) with native DFFs and 10 (17.9%) with PPDFFs following TKA or Total hip arthroplasty (THA) . Female predominance was significantly higher in the PPDFF group compared to native fractures (100% vs. 63%, p=0.023). All PPDFFs resulted from simple falls (100%), whereas the native group had a more diverse trauma profile (p=0.036). Fracture type, Charlson Comorbidity Index and postoperative complication rates were similar between groups (p=0.702, p=0.170, p=0.639, respectively).
Conclusion: PPDFFs constituted 17.9% of all DFFs in our series, aligning with reports from tertiary referral centers. These injuries predominantly affect elderly women and are strongly associated with low-energy falls. The findings underscore the need for preventive strategies such as osteoporosis management and fall prevention, as well as for timely surgical intervention and updated epidemiological data to optimize treatment planning and improve outcomes.
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