Plate Failure Following Plate Osteosynthesis in Periprosthetic Femoral Fractures

Overview

Journal Wien Klin Wochenschr

Publisher Springer

Specialty General Medicine

Date 2015 Jul 19

PMID 26187336

Citations 2

Authors

Sandra Boesmueller

Sebastian F Baumbach

Marcus Hofbauer

Gerald E Wozasek

Affiliations

Soon will be listed here.

Abstract

Background: Increasing numbers of total knee and hip arthroplasties result in a growing number of periprosthetic femoral fractures (PPFF). PPFF with a stable stem component are treated commonly with plate osteosynthesis. Therefore plate failure is seen as a major complication. The aim of this retrospective study was to investigate the patients' outcome after plate failure.

Methods: The database of a Level 1 trauma center was searched for all patients treated for a PPFF with plate osteosynthesis. Patients with plate failure were investigated specifically. Standard demographic data, details on initial arthroplasty, trauma, and treatment were recorded for all patients. All fractures were classified and their outcome reviewed.

Results: Seven (8.8%) out of 80 patients treated with plate osteosynthesis following PPFF met our inclusion criterion being plate failure. All these patients were female, with an average age at primary surgery of 74 ± 13 years and a mean follow-up of 885 days (range, 264-2549). Four patients suffered a PPFF after total hip arthroplasty (THA) (2 Vancouver Type B1 and 2 Type C) and three after total knee arthroplasty (TKA) (Lewis-Rorabeck Type II). Following plate failure, four patients healed uneventfully and three patients experienced complications such as pseudarthrosis, screw loosening, and further plate failure.

Conclusion: In patients with poor bone quality, bone graft, bone cement, and bone biologics have to be considered in revision surgery. Furthermore, long-stem revision and tumor prosthesis are an additional solution.

Citing Articles

Open reduction and locked compression plate fixation, with or without allograft strut, for periprosthetic fractures in patients who had a well-fixed femoral stem: a retrospective study with an average 2-year follow-up.

Lv H, Guo X, Wang Y, Zhang Z, Zou L, Xue H BMC Musculoskelet Disord. 2022; 23(1):69.

PMID: 35045862 PMC: 8772153. DOI: 10.1186/s12891-022-05008-2.

High Failure Rates of Locking Compression Plate Osteosynthesis with Transverse Fracture around a Well-Fixed Stem Tip for Periprosthetic Femoral Fracture.

Min B, Lee K, Cho C, Lee I, Kim B J Clin Med. 2020; 9(11).

PMID: 33266369 PMC: 7700227. DOI: 10.3390/jcm9113758.

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