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01-11-2014 | Original Article

Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study

Authors: Takahiro Niikura, Atsushi Sakurai, Keisuke Oe, Nao Shibanuma, Masaya Tsunoda, Akihiro Maruo, Etsuo Shoda, Sang Yang Lee, Yoshitada Sakai, Masahiro Kurosaka

Published in: Journal of Orthopaedic Science | Issue 6/2014

Abstract

Background

Osteosynthesis of periprosthetic femoral fractures around hip arthroplasties is challenging, and locking plate fixation has been found to be a reasonable treatment. However, there is a paucity of evidence of the extent to which patients recover their activities of daily living (ADL). The purpose of this study was to study the clinical results, particularly recovery of ADL, radiological results, and potential complications arising from the use of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties.

Methods

We conducted a retrospective, multi-center study. Patients with periprosthetic femoral fractures around hip arthroplasties who were treated by osteosynthesis with use of locking plates and who underwent follow-up for at least 6 months postoperatively were enrolled in the study. For each patient, recovery of ADL, in terms of social and ambulatory recovery and Parker mobility score, were compared before fracture and at last follow-up. Postoperative complications were investigated. Bony union, loss of reduction, and malunion were assessed radiologically.

Results

Thirty-two patients were enrolled in this study. Mean follow-up was 25.1 months. For 84.4, 68.8, and 53.1 % of patients, respectively, social status, ambulation, and Parker mobility score at last follow-up were determined to be equal to that before the fracture. Bony union was observed for 30 patients within the follow-up period. Four patients had not achieved bony union 6 months postoperatively. There was no loss of reduction, malunion, or implant breakage, and no infection. For one patient each, partial pullout of the locking screws and a supracondylar fracture at the plate end were observed, and additional surgery was required.

Conclusions

Our results reveal that locking plate fixation provided sufficient stability for satisfactory recovery of ADL for most elderly patients with periprosthetic femoral fractures around hip arthroplasties.

Haddad FS, Duncan CP, Berry DJ, Lewallen DG, Gross AE, Chandler HP. Periprosthetic femoral fractures around well-fixed implants: use of cortical onlay allografts with or without a plate. J Bone Joint Surg Am. 2002;84-A(6):945–50.PubMed

Ricci WM, Bolhofner BR, Loftus T, Cox C, Mitchell S, Borrelli J Jr. Indirect reduction and plate fixation, without grafting, for periprosthetic femoral shaft fractures about a stable intramedullary implant. J Bone Joint Surg Am. 2005;87(10):2240–5.PubMedCrossRef

Tsiridis E, Narvani AA, Timperley JA, Gie GA. Dynamic compression plates for Vancouver type B periprosthetic femoral fractures: a 3-year follow-up of 18 cases. Acta Orthop. 2005;76(4):531–7.PubMedCrossRef

Kääb MJ, Stöckle U, Schütz M, Stefansky J, Perka C, Haas NP. Stabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases. Arch Orthop Trauma Surg. 2006;126(2):105–10.PubMedCrossRef

O’Toole RV, Gobezie R, Hwang R, Chandler AR, Smith RM, Estok DM 2nd, Vrahas MS. Low complication rate of LISS for femur fractures adjacent to stable hip or knee arthroplasty. Clin Orthop Relat Res. 2006;450:203–10.PubMedCrossRef

Chakravarthy J, Bansal R, Cooper J. Locking plate osteosynthesis for Vancouver Type B1 and Type C periprosthetic fractures of femur: a report on 12 patients. Injury. 2007;38(6):725–33.PubMedCrossRef

Erhardt JB, Grob K, Roderer G, Hoffmann A, Forster TN, Kuster MS. Treatment of periprosthetic femur fractures with the non-contact bridging plate: a new angular stable implant. Arch Orthop Trauma Surg. 2008;128(4):409–16.PubMedCrossRef

Kobbe P, Klemm R, Reilmann H, Hockertz TJ. Less invasive stabilisation system (LISS) for the treatment of periprosthetic femoral fractures: a 3-year follow-up. Injury. 2008;39(4):472–9.PubMedCrossRef

Ebraheim NA, Gomez C, Ramineni SK, Liu J. Fixation of periprosthetic femoral shaft fractures adjacent to a well-fixed femoral stem with reversed distal femoral locking plate. J Trauma. 2009;66(4):1152–7.PubMedCrossRef

10.

Bryant GK, Morshed S, Agel J, Henley MB, Barei DP, Taitsman LA, Nork SE. Isolated locked compression plating for Vancouver Type B1 periprosthetic femoral fractures. Injury. 2009;40(11):1180–6.PubMedCrossRef

11.

Ehlinger M, Bonnomet F, Adam P. Periprosthetic femoral fractures: the minimally invasive fixation option. Orthop Traumatol Surg Res. 2010;96(3):304–9.PubMedCrossRef

12.

Wood GC, Naudie DR, McAuley J, McCalden RW. Locking compression plates for the treatment of periprosthetic femoral fractures around well-fixed total hip and knee implants. J Arthroplasty. 2011;26(6):886–92.PubMedCrossRef

13.

Xue H, Tu Y, Cai M, Yang A. Locking compression plate and cerclage band for type B1 periprosthetic femoral fractures preliminary results at average 30-month follow-up. J Arthroplasty. 2011;26(3):467–71.PubMedCrossRef

14.

Ehlinger M, Adam P, Di Marco A, Arlettaz Y, Moor BK, Bonnomet F. Periprosthetic femoral fractures treated by locked plating: feasibility assessment of the mini-invasive surgical option. A prospective series of 36 fractures. Orthop Traumatol Surg Res. 2011;97(6):622–8.PubMedCrossRef

15.

El-Zayat BF, Ruchholtz S, Efe T, Fuchs-Winkelmann S, Krüger A, Kreslo D, Zettl R. NCB-plating in the treatment of geriatric and periprosthetic femoral fractures. Orthop Traumatol Surg Res. 2012;98(7):765–72.PubMedCrossRef

16.

Apivatthakakul T, Phornphutkul C, Bunmaprasert T, Sananpanich K, Fernandez Dell’Oca A. Percutaneous cerclage wiring and minimally invasive plate osteosynthesis (MIPO): a percutaneous reduction technique in the treatment of Vancouver type B1 periprosthetic femoral shaft fractures. Arch Orthop Trauma Surg. 2012;132(6):813–22.PubMedCrossRef

17.

Froberg L, Troelsen A, Brix M. Periprosthetic Vancouver type B1 and C fractures treated by locking-plate osteosynthesis: fracture union and reoperations in 60 consecutive fractures. Acta Orthop. 2012;83(6):648–52.PubMedCentralPubMedCrossRef

18.

Ruchholtz S, El-Zayat B, Kreslo D, Bücking B, Lewan U, Krüger A, Zettl R. Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur–a prospective study of 41 patients. Injury. 2013;44(2):239–48.PubMedCrossRef

19.

Ebraheim NA, Sochacki KR, Liu X, Hirschfeld AG, Liu J. Locking plate fixation of periprosthetic femur fractures with and without cerclage wires. Orthop Surg. 2013;5(3):183–7.PubMedCrossRef

20.

Graham SM, Moazen M, Leonidou A, Tsiridis E. Locking plate fixation for Vancouver B1 periprosthetic femoral fractures: a critical analysis of 135 cases. J Orthop Sci. 2013;18(3):426–36.PubMedCrossRef

21.

Wagner M. General principles for the clinical use of the LCP. Injury. 2003;34(Suppl 2):B31–42.PubMedCrossRef

22.

Buttaro MA, Farfalli G, Paredes Núñez M, Comba F, Piccaluga F. Locking compression plate fixation of Vancouver type-B1 periprosthetic femoral fractures. J Bone Joint Surg Am. 2007;89(9):1964–9.PubMedCrossRef

23.

Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br. 1993;75(5):797–8.PubMed

24.

Masri BA, Meek RM, Duncan CP. Periprosthetic fractures evaluation and treatment. Clin Orthop Relat Res. 2004;420:80–95.PubMedCrossRef

25.

Johansson JE, McBroom R, Barrington TW, Hunter GA. Fracture of the ipsilateral femur in patients with total hip replacement. J Bone Joint Surg Am. 1981;63(9):1435–42.PubMed

26.

Dijkman BG, Sprague S, Schemitsch EH, Bhandari M. When is a fracture healed? Radiographic and clinical criteria revisited. J Orthop Trauma. 2010;24(Suppl 1):S76–80.PubMedCrossRef

27.

Laurer HL, Wutzler S, Possner S, Geiger EV, El Saman A, Marzi I, Frank J. Outcome after operative treatment of Vancouver type B1 and C periprosthetic femoral fractures: open reduction and internal fixation versus revision arthroplasty. Arch Orthop Trauma Surg. 2011;131(7):983–9.PubMedCrossRef

28.

Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury. 2003;34(Suppl 2):B63–76.PubMedCrossRef

29.

Parvizi J, Vegari DN. Periprosthetic proximal femur fractures: current concepts. J Orthop Trauma. 2011;25(Suppl 2):S77–81.PubMedCrossRef

Title: Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study
Authors: Takahiro Niikura
Atsushi Sakurai
Keisuke Oe
Nao Shibanuma
Masaya Tsunoda
Akihiro Maruo
Etsuo Shoda
Sang Yang Lee
Yoshitada Sakai
Masahiro Kurosaka
Publication date: 01-11-2014
Publisher: Springer Japan
Published in: Journal of Orthopaedic Science / Issue 6/2014
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI: https://doi.org/10.1007/s00776-014-0622-3

2024 ASCO Annual Meeting

Springer Medicine

Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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