title: Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques.
abstract: This study evaluated 5 currently used periprosthetic femoral shaft fracture fixation techniques to determine which technique provided the greatest fixation stability. Periprosthetic fractures in 30 synthetic femurs were fixed with a plate with cables, plate with proximal cables and distal bicortical screws (Ogden concept), plate with proximal unicortical screws and distal bicortical screws, plate with proximal unicortical screws and cables and distal bicortical screws, or 2 allograft cortical strut grafts with cables. These specimens were then tested in 3 physiologic loading modes. The plate constructs with proximal unicortical screws and distal bicortical screws or with proximal unicortical screws, proximal cables, and distal bicortical screws were significantly more stable in axial compression, lateral bending, and torsional loading than the other fixation constructs studied.
authors.affiliation: Musculoskeletal Research Center, Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10003, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Dennis
authors.forename: J A
authors.initials: JA
authors.lastname: Simon
authors.forename: F J
authors.initials: FJ
authors.lastname: Kummer
authors.forename: K J
authors.initials: KJ
authors.lastname: Koval
authors.forename: P E
authors.initials: PE
authors.lastname: DiCesare
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D012307:Risk Factors; D016896:Treatment Outcome