Single staged buttress plating with constrained knee arthroplasty for distal femur fractures in the elderly.

Treatment options for distal femur fractures include open reduction internal fixation (ORIF), arthroplasty, or a hybrid of both. We present a 76 year old female with left knee pain secondary to known osteoarthritis, known lateral condyle insufficiency fracture, and an acute medial condyle fracture. In order to solve the acute and chronic problems in a single procedure, a combined ORIF and constrained condylar knee (CCK) arthroplasty was performed. Arthroplasty alone would have required a highly constrained distal femur replacement, and ORIF alone would have caused prolonged immobilization and continued morbidity from unaddressed chronic problems. We chose a CCK as a less constrained implant would not have protected our ORIF which contained the medial collateral ligament attachment. This technique avoids the complications of ORIF alone, and avoids the known complications of increased constraint in total knee arthroplasty.