title: Locking compression plates for the treatment of periprosthetic femoral fractures around well-fixed total hip and knee implants.
abstract: There are currently few published studies examining the use of locking compression plates for the treatment of periprosthetic femoral fractures. Fifteen total hip or knee arthroplasty patients with 16 Vancouver type B1 and C fractures with an average age of 76 years were fixed and followed clinically and radiographically for 2 years. Fourteen patients achieved radiographic union by 6 months, and 13 patients were ambulatory by 6 months. There were no intraoperative complications. In summary, locking plates offer a viable treatment option for these difficult fractures. We advocate a minimum of 10 cortices of fixation (with unicortical or bicortical screws and cable combinations) above and below the fracture. Bone grafting should be used if the soft tissue envelope is violated with extensive dissection, and cortical struts should be considered in cases of failed hardware and revision fixation.
authors.affiliation: Division of Orthopaedic Surgery, Queen's University, Kingston Ontario, Canada.
authors.forename: Gavin C A
authors.initials: GC
authors.lastname: Wood
authors.forename: Doug R
authors.initials: DR
authors.lastname: Naudie
authors.forename: James
authors.initials: J
authors.lastname: McAuley
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCalden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome