title: High union rates of locking compression plating with cortical strut allograft for type B1 periprosthetic femoral fractures.
abstract: Unified classification system (UCS) type B1 periprosthetic femoral fractures are associated with many complications, and management decisions continue to be controversial. The purpose of this study was to evaluate outcomes of UCS type B1 periprosthetic femoral fractures treated by locking compression plating with strut allograft augmentation.
  
  
  
  We retrospectively reviewed 17 consecutive UCS type B1 periprosthetic femoral fractures treated by open reduction and internal fixation using a lateral locking compression plate supplemented with an anterior cortical strut allograft. There was one man and 16 women with an average age of 74 years (range, 57-92 years). All had a cementless hip arthroplasty, and eight of the arthroplasties were revisions.
  
  
  
  The mean duration of follow-up was 28 months (range, 12-74 months). All 17 fractures healed successfully at a mean of 20 weeks (range, 12-30 weeks). The mean post-operative Harris hip score was 86 points (range, 77-95 points). No mechanical complications such as failure of plate or screws and malalignment were noted. According to the graft-remodeling classification of Emerson et al., a partial bridging was observed in nine and a complete bridging in eight. Two patients required a removal of the plate due to irritation of the iliotibial band. No femoral stem loosening or deep infection was observed.
  
  
  
  Our findings indicate that open reduction and internal fixation of UCS type B1 periprosthetic femoral fractures using a lateral locking compression plate supplemented with anterior cortical strut allograft provides adequate mechanical stability of fracture fixation and enhances the fracture healing.
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 135-710, South Korea.
authors.forename: Ingwon
authors.initials: I
authors.lastname: Yeo
authors.affiliation: Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, 134-727, South Korea.
authors.forename: Kee-Hyung
authors.initials: KH
authors.lastname: Rhyu
authors.affiliation: Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, 131-795, South Korea.
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 135-710, South Korea.
authors.forename: Yoon-Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 135-710, South Korea. limsj70@gmail.com.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Lim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001860:Bone Plates; D016025:Bone Transplantation; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D014184:Transplantation, Homologous
keywords: Cortical strut allograft; Hip arthroplasty; Locking compression plate; Periprosthetic femur fractures