[Periprosthetic Fractures. Long-term Results After Plate Osteosynthesis Stabilization]

Overview

Journal Unfallchirurg

Date 2008 Jul 1

PMID 18587547

Citations 9

Authors

M Rupprecht

L Grossterlinden

F Barvencik

M Gebauer

D Briem

J M Rueger

W Lehmann

Affiliations

Soon will be listed here.

Abstract

Background: Due to the increasing age of patients and the rising number of joint replacements, the incidence of periprosthetic fractures (PPF) is also increasing. The treatment should be selected with knowledge of the prefracture interface status and the type of fracture involved. The aim of this study was to evaluate our treatment of PPF with long-term follow-up.

Patients And Methods: From 1988 to 2006, 99 patients with PPF were treated in our department. In 86 cases a plate osteosynthesis was used. After a mean time of 7.3+/-2.8 years, we studied 56 patients and monitored their complications.

Results: The most diagnosed fracture was Johansson type III (44%). Seventy-one patients were treated with a conventional and 15 with locking-plate osteosynthesis. In 15 cases (17.5%) we found severe complications (3 breaks and 3 dislocations of the plates, 6 cases of pseudarthrosis, 2 deep wound infections, and 1 case of postoperative bleeding).

Conclusion: Due to the minor frequency of severe complications, plate osteosynthesis of a periprosthetic fracture with a loosened interface is a good therapeutic option for individual patients, particularly for geriatric patients and those without disorders specific to a loosened interface.

Citing Articles

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Plate failure following plate osteosynthesis in periprosthetic femoral fractures.

Boesmueller S, Baumbach S, Hofbauer M, Wozasek G Wien Klin Wochenschr. 2015; 127(19-20):770-8.

PMID: 26187336 DOI: 10.1007/s00508-015-0818-3.

Periprosthetic femoral fracture - an interdisciplinary challenge.

Hagel A, Siekmann H, Delank K Dtsch Arztebl Int. 2014; 111(39):658-64.

PMID: 25323023 PMC: 4200415. DOI: 10.3238/arztebl.2014.0658.

[Periprosthetic and interimplant femoral fractures: Biomechanical analysis].

Rupprecht M, Schlickewei C, Fensky F, Morlock M, Puschel K, Rueger J Unfallchirurg. 2014; 118(12):1025-32.

PMID: 24893727 DOI: 10.1007/s00113-014-2591-6.

[Treatment of periprosthetic femoral fractures after total hip arthroplasty with specially constructed retrograde hollow nails].

Szalay G, Meyer C, Mika J, Schnettler R, Thormann U Oper Orthop Traumatol. 2014; 26(6):611-24.

PMID: 24535620 DOI: 10.1007/s00064-013-0236-5.

References

Whittaker R, Sotos L, RALSTON E . Fractures of the femur about femoral endoprostheses. J Trauma. 1974; 14(8):675-94. DOI: 10.1097/00005373-197408000-00004. View

Christensen C, Seger B, Schultz R . Management of intraoperative femur fractures associated with revision hip arthroplasty. Clin Orthop Relat Res. 1989; (248):177-80. View

Abendschein W . Periprosthetic femur fractures--a growing epidemic. Am J Orthop (Belle Mead NJ). 2003; 32(9 Suppl):34-6. View

Pierson J, Jasty M, Harris W . Techniques of extraction of well-fixed cemented and cementless implants in revision total hip arthroplasty. Orthop Rev. 1993; 22(8):904-16. View

Wahl B, Grasshoff H, Meinecke I, Neumann H . [Results of operative therapy of periprosthetic femur shaft fractures in total hip endoprostheses]. Zentralbl Chir. 2001; 126(1):50-4. DOI: 10.1055/s-2001-11726. View

Lindahl H, Malchau H, Oden A, Garellick G . Risk factors for failure after treatment of a periprosthetic fracture of the femur. J Bone Joint Surg Br. 2005; 88(1):26-30. DOI: 10.1302/0301-620X.88B1.17029. View

Peterson T, Riester U, Wissing H . [Replacement of hip prostheses--technical aspects and personal results]. Unfallchirurgie. 1996; 22(4):160-7. View

Bethea 3rd J, DEANDRADE J, Fleming L, Lindenbaum S, Welch R . Proximal femoral fractures following total hip arthroplasty. Clin Orthop Relat Res. 1982; (170):95-106. View

Gruner A, Hockertz T, Reilmann H . [Periprosthetic fractures: classification, management, therapy]. Unfallchirurg. 2004; 107(1):35-49. DOI: 10.1007/s00113-003-0698-2. View

10.

Mittlmeier T, Beck M . [Retrograde medullary locking nail in periprosthetic distal femoral fracture after condylar knee joint replacement]. Unfallchirurg. 2005; 108(6):497-501. DOI: 10.1007/s00113-005-0956-6. View

11.

Mont M, Maar D . Fractures of the ipsilateral femur after hip arthroplasty. A statistical analysis of outcome based on 487 patients. J Arthroplasty. 1994; 9(5):511-9. DOI: 10.1016/0883-5403(94)90098-1. View

12.

Johansson J, McBroom R, BARRINGTON T, Hunter G . Fracture of the ipsilateral femur in patients wih total hip replacement. J Bone Joint Surg Am. 1981; 63(9):1435-42. View

13.

Crockarell Jr J, Berry D, Lewallen D . Nonunion after periprosthetic femoral fracture associated with total hip arthroplasty. J Bone Joint Surg Am. 1999; 81(8):1073-9. DOI: 10.2106/00004623-199908000-00003. View

14.

Jensen J, Barfod G, Hansen D, Larsen E, Linde F, Menck H . Femoral shaft fracture after hip arthroplasty. Acta Orthop Scand. 1988; 59(1):9-13. DOI: 10.3109/17453678809149334. View

15.

Dennis M, Simon J, Kummer F, Koval K, DiCesare P . Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques. J Arthroplasty. 2000; 15(4):523-8. DOI: 10.1054/arth.2000.4339. View

16.

Taylor M, Meyers M, HARVEY Jr J . Intraoperative femur fractures during total hip replacement. Clin Orthop Relat Res. 1978; (137):96-103. View

17.

Iesaka K, Kummer F, Di Cesare P . Stress risers between two ipsilateral intramedullary stems: a finite-element and biomechanical analysis. J Arthroplasty. 2005; 20(3):386-91. DOI: 10.1016/j.arth.2004.05.002. View

18.

Siegmeth A, Menth-Chiari W, Wozasek G, Vecsei V . [Periprosthetic femur shaft fracture. Indications and outcome in 51 patients]. Unfallchirurg. 1999; 101(12):901-6. DOI: 10.1007/s001130050356. View

19.

Beals R, TOWER S . Periprosthetic fractures of the femur. An analysis of 93 fractures. Clin Orthop Relat Res. 1996; (327):238-46. DOI: 10.1097/00003086-199606000-00029. View

20.

Fitzgerald Jr R, Brindley G, Kavanagh B . The uncemented total hip arthroplasty. Intraoperative femoral fractures. Clin Orthop Relat Res. 1988; (235):61-6. View