Treating the fractured femur along with an arthritic knee-A Novel two hit surgery

ABSTRACT: Introduction: Distal femur fractures accounts to about 0.4% of all fractures. Nevertheless, despite the progress made in treatment choices and surgical procedures, there is still no agreement on the appropriate kind of implant to be utilized in certain situations for the management of these fractures. In scenarios like our cases with combined grade IV osteoarthritis with shaft of femur peri implant fracture the surgical approach, implant of choices remains the game changers. CASE REPORT: In this case report, we present to you a 72 years old female, diagnosed to have peri implant fracture with grade IV primary osteoarthritis of knee , who underwent femur retrograde IMIL nailing and total knee arthroplasty in the same sitting. The treatment of this case was challenging because of the associated knee osteoarthritis with the fracture. Early mobilization was started after regular physiotherapy. Conclusion: The surgical method we had adopted minimized further soft tissue disturbance around the fracture site, especially the blood vessel disruption, by using the same approach as the arthroplasty. Early rehabilitation and a post op care plays a vital role next to a good fixation. Keywords: Distal femur fracture, Knee OsteoArthritis, Arthroplasty, Femur nailing