The Use of the Taylor Spatial Frame (Tsf) External Fixation for A Periprosthetic Tibial Fracture

The majority of periprosthetic fractures around the knee occur at the supra- and diacondylar regions of the distal femur, with a reported incidence of 0.3% to 5.5% for patients with primary knee replacement. A series of over 17000 total knee arthroplasties reported by the Mayo Clinic Joint Registry published in 1999 indicated that postoperative tibia fracture occurred in 0.4% of cases after primary TKA.

4 types in Felix classification: Type I fractures occur at the tibial plateau. Type II fractures occur adjacent to the prosthesis stem. Type III fractures occur distal to the stem. Type IV fractures involve the tibial tubercle. The fracture types are further classified according to whether the prosthesis was well fixed (A) or loose (B) based on the radiographic appearances and whether the fracture occurred intraoperatively (C)

ORIF is indicated if the prosthesis is well-fixed. However, plats and screw constructs are limited by the available bone to pass bicortical screws proximally, which can lead to insufficient fixation and calls for adjunctive fixation.

Dual plating is often required. However, using multiple incisions increases the risk of skin necrosis and deep infection.

To the best of our knowledge, the use of a TSF external fixator to treat periprosthetic tibial fracture, so far has not been reported in the English literature. This method was adopted in order to overcome the difficulties and complications of the more common ORIF treatment.

A 48-year-old lady who sustained a periprosthetic Felix type 2A fracture after a road accident, was treated successfully.