[Periprosthetic fractures. Long-term results after plate osteosynthesis stabilization].
BACKGROUND
Due to the increasing age of patients and the rising number of joint replacements, the incidence of periprosthetic fractures (PPF) is also increasing. The treatment should be selected with knowledge of the prefracture interface status and the type of fracture involved. The aim of this study was to evaluate our treatment of PPF with long-term follow-up.


METHODS
From 1988 to 2006, 99 patients with PPF were treated in our department. In 86 cases a plate osteosynthesis was used. After a mean time of 7.3+/-2.8 years, we studied 56 patients and monitored their complications.


RESULTS
The most diagnosed fracture was Johansson type III (44%). Seventy-one patients were treated with a conventional and 15 with locking-plate osteosynthesis. In 15 cases (17.5%) we found severe complications (3 breaks and 3 dislocations of the plates, 6 cases of pseudarthrosis, 2 deep wound infections, and 1 case of postoperative bleeding).


CONCLUSIONS
Due to the minor frequency of severe complications, plate osteosynthesis of a periprosthetic fracture with a loosened interface is a good therapeutic option for individual patients, particularly for geriatric patients and those without disorders specific to a loosened interface.
Rupprecht
M
M
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinik Hamburg Eppendorf, Hamburg, Deutschland. mrupprec@uke.uni-hamburg.de
Grossterlinden
L
L
Barvencik
F
F
Gebauer
M
M
Briem
D
D
Rueger
J M
JM
Lehmann
W
W
D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000209:etiology* / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000209:etiology* / Q000601:surgery*; D008297:Male; D011475:Prosthesis Failure; D016896:Treatment Outcome