Nonunion of the distal femur can be very challenging to treat and often has a devastating impact on patient function and quality of life. Gmrs proximal tibial surgical protocol description of the proximal tibial modular replacement system the gmrs system was developed to meet the unique needs of patients who require reconstruction of large segmental defects for tumors, failed previous arthroplasty, or trauma. Varus collapse of comminuted distal femur fractures after open reduction and internal fixation with a lateral condylar buttress plate. Revision distal femoral arthroplasty with the compress. Patella kinematics have been enhanced by incorporating a deepened patellar track to articulate with the duracon patellae. The arrow ezio intraosseous vascular access system is indicated for adult and pediatric patients any time vascular access is difficult to obtain in emergent, urgent or medically necessary situations for 24 hours contraindications fracture of target bone infection at area of insertion inability to identify landmarks. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. Touch on both introduction modern fixation techniques locking plates ss, titanium, polyaxial, far cortex locking sc specific imn minimally invasive large cancellous bone surface union rates 8497%. The purpose of this study was to analyze the complications and clinical outcomes of lp treatment for distal femoral fractures. Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. A fixed boundary condition has been applied on the distal end of the femur and the hip contact force has been applied on the head of the femur in order to calculate the normal stresses for normal walking and standing up during this boundary condition. Global modular replacement system one system, one vision.
Nonunions around the knee joint pubmed central pmc. Sep 22, 2017 the modified stoppa approach in the treatment of a t shaped acetabular fracture surgical video tech duration. Biomechanical analysis of the human femur bone during normal. The system allows for polyaxial screw placement with subsequent screw locking for im proved stability especially within osteopenic. Distal femoral periprosthetic fractures are on the rise. Distal femur fractures and its treatment with distal femur. All surgical techniques are available as pdf files. A guide to the placement of this mark is the linea aspera on the posterior aspect of the. Reconstruction was performed with the gmrs combined with the mrh.
Distal femur fractures are challenging injuries, frequently resulting in complications like nonunions, malunions, knee stiffness and infections. Gmrs proximal femoral surgical protocol 2 marking anterior aspect of femur a longitudinal line representing the anterior point on the femur should now be marked distal to the resection level to aid in rotational orientation of the prosthesis figure 2. Anatomy distal femur femur transitions from cylinder to condyles medial condyle extends further inferior cancellous bone trapezoidal shape what this means for fixation avoid notch and concomitant injury to cruciate ligaments avoid penetration of medial cortex with anterior screws x x deforming forces quadriceps. Short and mid term results of revision total knee arthroplasty with.
Lcp periarticular plating system the lcp periarticular plating system is capable of addressing. Utilizes gmrs small axle, small bushings and mrh bumper utilizes modular rotating hinge axle, bushings, and bumper distal femur distal femur with allpoly tibial component while clinical history is the foundation for the gmrs system, our stateoftheart technology drives the systems outstanding performance. Please vote below and help us build the most advanced adaptive learning platform in medicine. Despite technique suggestions from anecdotal and some early reports, knowledge about risk factors for failure, nonunion nu, and revision is limited. The compress compliant prestress cps implant can reconstruct the femur even when there is little remaining bone. Structural failure of a modern knee tumor megaendoprosthesis. Distal femur fractures and its treatment with distal femur locking plate kanav padha, sandeep singh, abdul ghani, harish dang the incidence of distal femur fractures is around 37 100,000 patients per year. Jan 10, 2016 operative treatment of acute distal femur fractures. The information contained in this document is intended for healthcare professionals only.
Straight and bowed connection piece for total femur 80mm, 90mm left and right distal femoral component, pressfit stems with titanium plasma spray and. It differs from traditional stemmed prostheses because it requires only 4 to 8 cm of residual bone for. Tomofix medial distal femur plate surgical technique depuy synthes companies 1 warning. Distal femur distal femur with allpoly tibial component while clinical history is the foundation for the gmrs system, our. Distal condylar screws are parallel to the joint surface to provide a stable support structure in the metaphyseal region multiple points of fixation increased strength optimized fit percutaneous instrumentation stable support inspired by anatomy inspired by simplicity fracturespecific solutions proximal femur.
The treatment of femoral subtrochanteric fractures with the. The distal femoral nail dfn is indicated for the stabilization of fractures of the distal femur. Dfn distal femoral nail surgical technique standard locking spiral blade locking. The purpose of this site is to serve as the resource for anyone interested in learning more about the ldf as a site to measure by dxa for assessment of bone density. Class 2 device recall global modular replacement system gmrs. Stryker sent urgent product recall notification letters and product accountability forms via fedex on 12212007, return receipt requested. The lateral surface of this notch is elevated projecting more anteriorly than the medial boundary of the notch.
Class 2 device recall gmrs proximal femoral surgical protocol. Patella kinematics have been improved by incorporating a deepened patellar track to articulate with the duracon patellae. Stryker distal femoral growing prosthesis components and system. Gmrs distal femoral surgical protocol introduction the gmrs distal femoral components are based on over a quarter of a century of clinical history. The diversity of surgical options for the management of distal femoral fractures reflects the challenges inherent in these injuries. Gmrs proximal femoral surgical protocol introduction the gmrs proximal femoral components are based on over a decade of clinical history. The gmrs proximal femoral components are fully compatible with all stryker cobaltchrome v40. It consists primarily of a proximal femur plate, a distal femur plate, and a curved femur shaft plate. Omar al bardan only the paranoid survive 8,712 views.
What is new in distal femur periprosthetic fracture fixation. Strykers gmrs represents another significant option in modular replacement systems as a solution. If the fractures around hip are excluded, 31% femoral fractures involve distal portion 1. Gmrs global modular knee replacement system from stryker. Modular prostheses of the distal femur were initially developed for the treatment of. Patients with failed distal femoral megaprostheses often have bone loss that limits reconstructive options and contributes to the high failure rate of revision surgery. Distal femoral reconstruction following failed total knee arthroplasty. Gmrs cemented stem options available for the growing distal femur. Orthopaedics gmrs proximal tibial surgical protocol. Orthopaedics gmrs proximal tibial surgical protocol this publication sets forth detailed recommended procedures for using stryker orthopaedics devices and instruments. Positive results have been published by researchers with implants such as distal femur nail, dynamic condylar screw and even addition of a medial plate to a distal femur locking plate for treating distal femur fractures.
To study the outcome of subtrochanteric hip fractures treated with proximal lateral femur locking plate. Standard periloc radiolucent targeter instrumentation facilitates streamlined minimally invasive fixation of proximal femur fractures. Monoaxial locking plate for treating distal femur fractures. Fractures of the distal femur whether supracondylar. An urgent product recall letter dated 172008, was sent to surgeons who are gmrs users, advising that the gmrs proximal femoral components are not compatible with alumina ceramic heads.
Oct 01, 2016 distal femur locking plate is still the way forward for treating distal femur fractures. Martinet et al epidemiology of fractures of the distal femur statistics from ao documentation from the 1st jan. The epidemiology of fractures of the distal femur sciencedirect. From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus is on creating a welldesigned plating system, giving you more. Pdf what is new in distal femur periprosthetic fracture. Distal femur lecture orthopaedic trauma association. Ncb periprosthetic femur plate system surgical technique. Nov 30, 2017 this feature is not available right now. What is the distal femur produced into that articulates with the tibia. A guide to the placement of this mark is the linea aspera on the posterior aspect of the femur. Many surgical methods have been described for the treatment of these nonunions including external fixation, intramedullary nailing, arthroplasty, and fixed. These fractures are frequently comminuted and intraarticular, and they often involve osteoporotic bone, which makes it difficult to reduce and hold them while maintaining joint function and overall limb alignment. The neck length has been increased to improve range of motion and better meet the needs of various patient anatomies.
Nonunions of the distal femur are relatively rare but can occur with or without previous surgery. Orthopaedics gmrs proximal femoral surgical protocol. If there was a lack of femoral condyles or massive lack of distal femur, the gmrs was used as an alternative for amputation. From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus is on creating a welldesigned plating system, giving you more time to focus on other things. Trauma 101 clearwater 2016 john d wyrick md university of cincinnati introduction help preventtreat the nonunion. Clinical outcomes of locked plating of distal femoral.
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