Distal femoral replacement for a periprosthetic fracture: a method for removing the distal fragment

BACKGROUND Distal femoral replacement is becoming an increasingly common procedure for patients with distal femoral fractures above a total knee arthroplasty and as revision knee arthroplasty becomes more complex.1 The femoral prosthesis must be excised with its accompanying distal bone fragment. Release of this fragment from soft tissue attachments at the knee may be time consuming as this fragment can be difficult to control. There is also a significant risk of vascular or neurological injury if dissection occurs away from the bone–soft tissue interface.