PURPOSE OF THE STUDY To evaluate the outcomes and complications using cemented megaprosthesis in elderly patients with distal femur nonunions (DFN). MATERIALS AND METHODS Between 2012 and 2016, 24 patients of DFN with an average age of 71.8 years (66-83) and an average 1.9(1-3) prior surgery was managed with distal femur replacement using cemented modular endoprosthesis. Outcomes were analysed on the following criteria: implant status, complications, knee range of motion, Knee Society Score (KSS) and Musculoskeletal Tumor Society (MSTS) score. RESULTS All patients were extremely satisfied with their outcomes. At an average 22.1 months (10-43) follow-up, patients had an average 69.5° (40°-110°) knee flexion, an average KSS of 75.7 (63-88) and an average MSTS score of 19.3 (17-25). Four patients died at an average 21.3 months after surgery due to causes unrelated to the fracture. One patient (4.1%) had implant-related complication; deep infection which required debridement and intravenous antibiotics. There were no late amputations or peri-operative deaths and no patient had aseptic loosening of components. CONCLUSION By permitting immediate full weight-bearing ambulation and with most patients returning to an acceptable functional status, cemented megaprosthesis is a viable and useful single-stage management option in elderly patients with DFN.

中文翻译：

---

老年患者股骨远端骨不连的大假体-二十四例经验。

研究目的为了评估老年股骨远端骨不连（DFN）患者使用骨水泥巨大假体的结果和并发症。材料与方法在2012年至2016年之间，采用骨水泥模块内置假体置换术治疗了24例平均年龄71.8岁（66-83），平均术前1.9（1-3）的DFN患者。根据以下标准分析结局：种植体状态，并发症，膝关节活动范围，膝关节社会评分（KSS）和肌肉骨骼肿瘤学会（MSTS）评分。结果所有患者对他们的结果都非常满意。在平均22.1个月（10-43）的随访中，患者平均屈膝69.5°（40°-110°），平均KSS为75.7（63-88），平均MSTS评分为19.3（17- 25）。四名患者平均死亡21。手术后3个月因与骨折无关的原因。1例患者（4.1％）有与种植体相关的并发症。需要清创术和静脉注射抗生素的深层感染。无晚期截肢或围手术期死亡，无患者无菌性松动。结论通过允许立即进行完全负重行走，并使大多数患者恢复到可接受的功能状态，骨水泥固定假体对于DFN老年患者是一种可行且有用的单阶段治疗选择。