Stabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases.
BACKGROUND
Periprosthetic fractures of the femur present a challenging surgical problem. The aim of this study was to retrospectively evaluate the outcome of periprosthetic fractures stabilised with an angular stable, less invasive stabilisation system (LISS).


METHODS
Thirteen patients (ten total hip-, two total knee-, one total hip- and knee-arthroplasty) with periprosthetic fractures were treated with the LISS internal fixator (in ten cases minimal invasive). Six patients had previous operations due to periprosthetic fractures. The average follow-up period was 20 months, follow-up rate 85%.


RESULTS
All fractures showed radiographic fracture healing without implant loosening. Except one patient, all patients had returned to their pre-operative activity level. No early post-operative complications were seen. There was one implant failure after 4 months and two cases of malunion.


CONCLUSIONS
The cases showed the internal fixator to be effective for the stabilisation of periprosthetic fractures, even in cases of poor bone quality with good functional outcomes. The internal fixator, with the option of minimal invasive application, is the preferred method of osteosynthesis in periprosthetic fractures.
Kääb
M J
MJ
Center for Musculosceletal Surgery, Charité Universitätsmedizin Berlin, Schumannstrasse 20, Berlin, Germany. max.kaeaeb@charite.de
Stöckle
U
U
Schütz
M
M
Stefansky
J
J
Perka
C
C
Haas
N P
NP
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods; D001858:Bone Nails; D001860:Bone Plates; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome