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A 71-year-old woman incurred an unstable, comminuted supracondylar fracture of the femur above the tip of a GUEPAR prosthesis. The prosthesis was not loose. Immediate open reduction and internal fixation were performed using a segment cut from an intrarnedullary rod. This provided axial alignment and functioned as an internal stent with stable fixation of the fracture. Supplementary fixation with a plate and screws, cerclage wires, and an autogenous bone graft led to early mobilization, solid bony union, and an excellent functional result.
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Roscoe et al. (1989) studied this question.
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