Orthonotes
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Periprosthetic Distal Femur Fracture

Lewis–Rorabeck and Su classifications guide treatment; stability of the femoral component is the key decision point. Stable TKA → fixation (locking plate or retrograde nail if intercondylar box permits). Loose TKA → revision arthroplasty with long stem or distal femur replacement in poor bone stock. Biologic fixation with long, locked constructs reduces nonunion/varus collapse. Early ROM; weight‑bearing tailored to construct stability.