Partridge osteosynthesis: a prospective clinical study on the use of nylon cerclage bands and plates in the treatment of periprosthetic femoral shaft fractures.
OBJECTIVE
To evaluate the clinical use of the Partridge osteosynthesis in periprosthetic femoral fractures.


METHODS
Prospective nonrandomized clinical study.


METHODS
Over a ten-year period, 222 patients presenting with femoral fractures near the tip of a hip prosthesis were treated with the Partridge system, which employs elevated cerclage nylon bands and flexible elevated nylon plates. Sixty-five fractures were located cranial to the tip of the prosthesis (Whittaker Type I), 116 at the tip (type II), and forty-one distal to the tip of the prosthesis (Type III). The population consisted of 172 female and fifty male patients, with a mean age of 79.5 years. The mean duration between the index procedure and occurrence of the second fracture was 1.5 years. In 78 percent of the patients (173 out of 222), surgery was undertaken within forty-eight hours. Fracture reduction was open, and two nylon plates set at right angles to each other were secured to the femur with six to eight nylon bands. The mean operating time was fifty-five minutes, with an average blood loss of 550 milliliters.


RESULTS
There were minor wound healing problems in eighteen patients (12.6 percent); there were no deep wound infections. Thirty-three elderly patients died within the first month from medical complications. Of the 189 remaining patients, 60 percent regained their prefracture functional level within six months postoperatively, whereas 25 percent required a higher level of care. The mean time of the in-hospital stay was thirty-three days. Ninety-three percent of the fractures consolidated with abundant callus during the follow-up period of one year.


CONCLUSIONS
The indication for the use of this simple osteosynthesis method is swift convalescence by splinting the periprosthetic femoral fractures. Even with a loose prosthesis, the fracture often healed with abundant callus and the patient could be mobilized.
de Ridder
V A
VA
Department of Traumatology, Westeinde Ziekenhuis, Den Haag, The Netherlands.
de Lange
S
S
Koomen
A R
AR
Heatley
F W
FW
D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D002146:Bony Callus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004867:Equipment Design; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation*; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome