title: Clinical and radiological results of patients treated with orthogonal double plating for periprosthetic femoral fractures.
abstract: OBJECTIVE
  The aim of this study was to determine the outcome of surgically-treated periprosthetic femoral fractures with an orthogonal double plate system.
  
  
  METHODS
  We performed a retrospective study of ten patients (mean age 79.5 years) surgically treated for periprosthetic femoral fractures using orthogonal double plating (lateral and additional anterior plate position) from 2010 to 2013. The patients' demographic characteristics, complications and initial follow-up data were retrieved from our institutional database. After a minimum of six months post-surgery, we performed a radiological and clinical follow-up.
  
  
  RESULTS
  The surgical indications for orthogonal plating were heterogenic; five patients were treated for periprosthetic fractures around their total hip prosthesis. One was treated for a fracture around a total knee prosthesis and one for an interprosthetic fracture. Additionally, three patients were treated for postoperative implant failure after the stabilisation of periprosthetic fractures around a total hip prosthesis (one) or total knee prosthesis (two). Osteosynthesis was performed using locking compression plates exclusively (length between eight and 20 holes). After a mean follow-up of 22.6 months (range, six to 42 months), two patients died, but their deaths were due to old age morbidity and were unrelated to the surgery. Surgical revision for implant failure was necessary for only one female patient due to a breakage of the lateral plate. In addition, no other failures, such as infection or non-union, were observed. At the time of follow-up, seven out of ten patients were mobile and subjectively satisfied in regards to their outcome.
  
  
  CONCLUSIONS
  Based on a small number of cases, we were able to show for the first time that the use of orthogonal double plating is not associated with an increased rate of complications in patients with periprosthetic femoral fractures and stable components. Moreover, orthogonal double plating can be used successfully as a salvage procedure. At the time of follow up, seven out of ten patients were mobile. More cases must be investigated to validate our findings.
authors.affiliation: Clinic for Trauma, Orthopaedics and Sports Medicine, Hospital Barmherzige Brüder, 93049, Regensburg, Germany, franz.mueller@barmherzige-regensburg.de.
authors.forename: Franz Josef
authors.initials: FJ
authors.lastname: Müller
authors.forename: Michael
authors.initials: M
authors.lastname: Galler
authors.forename: Bernd
authors.initials: B
authors.lastname: Füchtmeier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001860:Bone Plates; D004868:Equipment Failure; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D011184:Postoperative Period; D011859:Radiography; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D024162:Second-Look Surgery
references.citation: J Arthroplasty. 2012 May;27(5):783-8
references.pmid: 22014657
references.citation: J Orthop Trauma. 2012 Apr;26(4):206-11
references.pmid: 22011633
references.citation: J Arthroplasty. 2000 Jun;15(4):523-8
references.pmid: 10884215
references.citation: Int Orthop. 2002;26(6):370-3
references.pmid: 12466871
references.citation: Int Orthop. 2014 Mar;38(3):489-94
references.pmid: 24091416
references.citation: Int Orthop. 2014 Jan;38(1):47-53
references.pmid: 24114243
references.citation: J Bone Joint Surg Am. 2008 May;90(5):1068-77
references.pmid: 18451400
references.citation: Orthop Clin North Am. 1999 Apr;30(2):209-14
references.pmid: 10196422
references.citation: Orthop Traumatol Surg Res. 2013 Sep;99(5):563-9
references.pmid: 23769162
references.citation: Acta Chir Orthop Traumatol Cech. 2013;80(2):131-7
references.pmid: 23562257
references.citation: J Arthroplasty. 2010 Sep;25(6 Suppl):124-8
references.pmid: 20558031
references.citation: Int Orthop. 2012 May;36(5):1045-50
references.pmid: 21983940
references.citation: Injury. 2009 Nov;40(11):1180-6
references.pmid: 19539924
references.citation: Arch Orthop Trauma Surg. 2011 Jul;131(7):983-9
references.pmid: 21331551
references.citation: Clin Orthop Relat Res. 1996 Jun;(327):238-46
references.pmid: 8641069
references.citation: J Am Acad Orthop Surg. 2004 Jan-Feb;12(1):12-20
references.pmid: 14753793
references.citation: J Bone Joint Surg Am. 2004;86-A Suppl 2:8-16
references.pmid: 15691103
references.citation: Instr Course Lect. 1995;44:293-304
references.pmid: 7797866
references.citation: Int Orthop. 2012 Sep;36(9):1915-21
references.pmid: 22638607