title: Treatment of type B periprosthetic femur fractures with curved non-locking plate with eccentric holes: Retrospective study of 43 patients with minimum 1-year follow-up.
abstract: BACKGROUND
  Periprosthetic femur fracture (PFF) is a serious complication after total hip arthroplasty that can be treated using different internal fixation devices. However, the outcomes with curved non-locking plates with eccentric holes in this indication have not been reported previously. The objectives of this study were to determine: (1) the union rate; (2) the complication rate; (3) autonomy in a group of patients with a Vancouver type B PFF who were treated with this plate.
  
  
  OBJECTIVE
  Use of this plate results in a high union rate with minimal mechanical complications.
  
  
  METHODS
  Forty-three patients with a mean age of 79 years ± 13 (41-98) who had undergone fixation of Vancouver type B PFF with this plate between 2002 and 2007 were included in the study. The time to union and Parker Mobility Score were evaluated. The revision-free survival (all causes) was calculated using Kaplan-Meier analysis. The average follow-up was 42 months ± 20 (16-90).
  
  
  RESULTS
  Union was obtained in all patients in a mean of 2.4 months ± 0.6 (2-4). One patient had varus malunion of the femur. The Parker Mobility Score decreased from 5.93 ± 1.94 (2-9) to 4.93 ± 1.8 (1-9) (P = 0.01). Two patients required a surgical revision: one for an infection after 4.5 years and one for stem loosening. The survival of the femoral stem 5 years after fracture fixation was 83.3% ± 12.6%.
  
  
  CONCLUSIONS
  Use of a curved plate with eccentric holes for treating type B PFF led to a high union rate and a low number of fixation-related complications. However, PFF remains a serious complication of hip arthroplasty that is accompanied by high morbidity and mortality rates.
authors.affiliation: Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland; Service de chirurgie orthopédique et traumatologie, institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address: alexandre.lunebourg@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Lunebourg
authors.affiliation: Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland; ITOLS, clinique de Genolier, 3, route de Muids, 1272 Genolier, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Mouhsine
authors.affiliation: Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Cherix
authors.affiliation: Service de chirurgie orthopédique et traumatologie, institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Ollivier
authors.affiliation: Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Chevalley
authors.affiliation: Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland; ITOLS, clinique de Genolier, 3, route de Muids, 1272 Genolier, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Wettstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001860:Bone Plates / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies
keywords: Femur; Fracture; Hip; ORIF; Plate; Prosthesis