TITLE

Locking Compression Plate Fixation of Vancouver Type-B1 Periprosthetic Femoral Fractures

AUTHOR(S)
Buttaro, M. A.; Farfalli, G.; Paredes Nüñez, M.; Comba, F.; Piccaluga, F.
PUB. DATE
September 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Sep2007, Vol. 89-A Issue 9, p1964
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Fractures occurring at or near the distal tip of a hip prosthesis with a stable femoral stem (Vancouver type-B fractures) are associated with many complications because of the inherently unstable fracture pattern. Locking compression plates use screws that lock into the plate allowing multiple points of unicortical fixation. Such unicortical fixation may lower the risk of damage to the cement mantle or a stable femoral stem during the treatment of a periprosthetic femoral fracture. The purpose of this study was to analyze clinically and radiographically a group of patients with a Vancouver type-B1 periprosthetic femoral fracture treated with open reduction and internal fixation with use of a locking compression plate. Methods: Fourteen consecutive patients (fourteen hips) with a Vancouver type-B1 periprosthetic femoral fracture were treated with a locking compression plate. There were five men and nine women with an average age of sixty- eight years at the time of fracture. All of the fractures occurred after a total hip arthroplasty performed with cement, and eleven of the arthroplasties were revisions. In addition to the plate, cortical strut allografts were used to stabilize five fractures. The patients were assessed clinically and radiographically. Results: The average duration of follow-up was twenty months. Eight fractures healed uneventfully at an average of 5.4 months. Three treatment constructs failed with fracture of the plate within twelve months after surgery. An additional three constructs also failed because of plate pullout. All failures except one occurred in constructs in which a cortical strut allograft had not been utilized. Conclusions: On the basis of the high failure rate in this series of patients, locking compression plates do not appear to offer advantages over other types of plates in the treatment of type-B1 periprosthetic femoral fractures. Despite the potential to preserve the cement mantle, the locked screws did not appear to offer good pullout resistance in this fracture type. We believe that supplementation with strut allografts should be used routinely if this type of locking compression plate is selected to treat these fractures.
ACCESSION #
26613658

 

Related Articles

  • The Mayo conservative hip: experience from a district general hospital. GILBERT, ROB E.; SALEHI-BIRD, SEEMA; GALLACHER, PETER D.; SHAYLOR, PHILLIP // Hip International;Jul-Sep2009, Vol. 19 Issue 3, p211 

    The Mayo Conservative Hip femoral prosthesis has been designed to optimise proximal femoral loading as well as preserving proximal femoral bone stock. Between October 2003 and May 2006, 42 patients (49 hips) underwent total hip replacement (THR) using the Mayo Conservative Hip femoral component....

  • Preventing acute infection in total hip prostheses implanted after external fixation of the femur: is there a need for a staged procedure? A. Massè; A. Aprato; E. Guzzi Susini // Journal of Orthopaedics & Traumatology;Mar2008, Vol. 9 Issue 1, p29 

    Abstract  We report two cases of acute infection of an uncemented femoral component in a hip prosthesis implanted after external fixation of a femoral fracture. In both cases, the surgical access did not cross over the pin scars. When the prosthesis was implanted the stem crossed one or...

  • Periprosthetic Fractures: A Problem on the Rise. Gross, Allan E. // Orthopedics;Sep2006, Vol. 29 Issue 9, p787 

    The article provides information on several treatment modalities for periprosthetic fractures of the hip. Treatment for postoperative fractures on the acetabular or femoral sides may include bone grafting or reconstruction with an acetabular cup. Classifications of postoperative fractures on the...

  • First Experience with Locked intramedullary nailing of the femur in Kashmir. Bashir, Arshad; Mir, B. A.; Halwai, M. A.; Qayum, Abdul // Internet Journal of Orthopedic Surgery;2008, Vol. 8 Issue 1, p11 

    An experience with 30 cases done between September 2002 and September 2004 at the Bone & Joint Surgery Hospital Srinagar Kashmir is reported. 30 cases of closed Diaphyseal femoral fractures were operated upon by closed antegrade intramedullary interlocking nailing and results assessed as per...

  • The ESOP-HA modular cementless femoral stem: a study of the results of 165 hip arthroplasties with a minimum of 10-year follow-up. Philippe, Michel; Martin, Elvira; Hummer, Jacques; Gacon, Gérard; Dambreville, Alain; Ray, André // European Journal of Orthopaedic Surgery & Traumatology;Dec2005, Vol. 15 Issue 4, p275 

    The authors report on more than 10 years’ experience of using a cementless femoral stem, with a two-piece modular design, for indications of primary prosthetic replacement. One hundred and sixty-five prostheses, inserted between 06/11/1991 and 31/12/1994, were reviewed. No patient was...

  • Are hip protectors correctly positioned in use? Minns, R. J.; Marsh, A.-M.; Chuck, A.; Todd, J. // Age & Ageing;Mar2007, Vol. 36 Issue 2, p140 

    There are many designs of hip protectors ranging from small elliptical shaped hard shell designs to large circular soft pads. They are held in position usually by being contained in a close fitting pocket on a garment that patients wear all the time they are at risk of sustaining a fracture of...

  • Proximal femur fractures problematic for elderly patients. Trace, Robert // Orthopaedics Today Europe;Jul/Aug2008, Vol. 11 Issue 4, p10 

    The article focuses on a report which reveals that proximal femur fractures are a major cause of morbidity in the elderly and comprise a significant proportion of acute orthopaedic admissions in Europe. Researchers examined the demographics and factors responsible for prolonged hospital stay...

  • Fixation of Periprosthetic Femur Fractures: A Biomechanical Analysis Comparing Cortical Strut Allograft Plates and Conventional Metal Plates. Peters, Christopher L.; Bachus, Kent N.; Davitt, James S. // Orthopedics;Jul2003, Vol. 26 Issue 7, p695 

    This study compared the stability of periprosthetic femur fractures fixed using cortical allograft struts with a metal plate. Cadaveric specimens were loaded in single-leg stance and stair climbing to 2250 N. Optimum stability in single-leg stance was achieved with two long struts medially and...

  • Finite element analysis of the effect of proximal interlocking on primary fixation of the Intra-Medullary Cruciate stem. Rina Sakai; Kanako Sato; Moritoshi Itoman; Kiyoshi Mabuchi // Journal of Orthopaedic Science;Jan2009, Vol. 14 Issue 1, p85 

    Abstract Background  The primary fixation of cementless hip prostheses is related to the shape of the stem. When there is a complication of loading in the rotational direction, the mechanical fixation of a hip stem is considered to provide good primary fixation. The purpose of this study...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics