Fixation of periprosthetic femoral shaft fractures adjacent to a well-fixed femoral stem with reversed distal femoral locking plate.
BACKGROUND
Numerous fixation methods have been described for the fixation of Vancouver type B1 periprosthetic fractures, but there have been a very few reports in the literature regarding the use of locking plates and their outcomes for this fracture. The objective of this study was to analyze clinically and radiographically, the results of fixation of Vancouver type B1 periprosthetic femoral fractures with a reversed distal femoral locking plate.


METHODS
Thirteen consecutive patients with Vancouver type B1 periprosthetic femoral fracture were stabilized with reversed distal femoral locking plate. Patients were followed up at 2, 6, 12, 24, and 48 weeks and yearly thereafter. They were assessed clinically and radiographically for union, delayed union, malunion, hardware failure, nonunion, infection, and stability of the femoral prosthesis.


RESULTS
The average duration of follow-up was 18 months. All fractures healed at an average of 14 weeks from fixation. Complications include superficial wound infection in one and flare-up of previous infection in one with union at 20 and 28 weeks, respectively. Twelve femoral prostheses were stable and all patients were ambulatory, with or without a walking aid at final follow-up. There was no hardware failure or nonunion.


CONCLUSIONS
Reversed distal femoral locking plate treatment is a feasible and effective choice for stabilization with femoral stem retention after Vancouver type B1 periprosthetic femoral fracture in an elderly patient population.
Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio 43614, USA.
Nabil A
NA
Ebraheim
Carlos
C
Gomez
Satheesh K
SK
Ramineni
Jiayong
J
Liu
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D005596:Fractures, Closed / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies