The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is rising due to the increasing number of TKAs performed annually and the growing elderly population. A periprosthetic fracture of the proximal tibia following TKA is a rare injury that may be a challenging clinical scenario. The case of an 84-year-old woman who sustained a periprosthetic tibial fracture 10 years after a TKA is presented. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment because the bone fragment was too small. This patient underwent fixation of her tibial fracture above the TKA using a five-ring Ilizarov external fixator. This allowed immediate full weight-bearing. The fixator was removed at 12 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 2 years from injury, she was fully weight-bearing without walking aids and had a knee range of motion (ROM) of 0–110°. To the best of our knowledge, this is the first report in which Ilizarov external fixation has been used for a periprosthetic tibial fracture after TKA.

中文翻译：

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Ilizarov外固定架治疗严重骨质疏松症的假体周围胫骨骨折：一例报告

全膝关节置换术（TKA）后假体周围骨折的发生率由于每年进行的TKA数量的增加和老年人口的增加而增加。TKA后胫骨近端假体周围骨折是罕见的损伤，可能是具有挑战性的临床情况。介绍了一个84岁的女性，该患者在TKA术后10年发生了假体周围胫骨骨折。该患者有多种危险因素。由于骨碎片太小，因此认为骨折不适合常规治疗。该患者使用五环Ilizarov外固定器固定了TKA上方的胫骨骨折。这可以立即完全承重。在第12周时取出固定器，此时骨折已完全愈合。在最近的随访中，受伤2年后，她在没有助行器的情况下完全负重，膝盖的运动范围（ROM）为0-110°。据我们所知，这是第一个报道将Ilizarov外固定支架用于TKA术后假体周围胫骨骨折的报道。