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Nail Plate Combination Technique for Native and Periprosthetic Distal Femur Fractures

Liporace, Frank A., MD; Yoon, Richard S., MD

doi: 10.1097/BOT.0000000000001332
Technical Trick

Summary: In the elderly, low-energy distal femur fractures (native or periprosthetic) can be devastating injuries, carrying high rates of morbidity and mortality, comparable with the hip fracture population. Poor, osteoporotic bone quality facilitates fracture in a vulnerable anatomical region, and as a result, operative fixation can be challenging. With goals of early mobilization to reduce subsequent complication risk, using the nail plate combination technique can offer stable, balanced fixation allowing for immediate weight bearing and early mobilization. We outline the rationale, technical steps, and early clinical outcomes after nail plate combination in the treatment of osteoporotic distal femur (native or periprosthetic) fractures.

Department of Orthopaedic Surgery, Division of Orthopaedic Trauma & Complex Adult Reconstruction, the Orthopedic Institute, Jersey City Medical Center—RWJBarnabas Health, Jersey City, NJ.

Reprints: Frank A. Liporace, MD, Chairman, Division of Orthopaedic Trauma & Complex Adult Reconstruction, Department of Orthopaedic Surgery, Jersey City Medical Center—RWJBarnabas Health, 377 Jersey Avenue, Suite 250A Jersey City, NJ 07302 (e-mail:

The authors report no conflict of interest.

Institutional review board approval was required and obtained before the completion of this manuscript.

Accepted August 28, 2018

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