title: Double plating in Vancouver type B1 periprosthetic proximal femur fractures: A biomechanical study.
abstract: Periprosthetic hip fractures are an increasing problem in modern orthopedic and trauma surgery. Many options for the operative treatment are available to the surgeon ranging from modern variable angular systems to standard plates, screws, and cerclages. However, there is no gold standard and therefore, the aim of this study, was to investigate the biomechanical characteristics of double plating versus a lateral standard plate in a Vancouver B1 fracture model. Ten 4th generation composite femora were used to implant cementless total hip prosthesis and create Vancouver B1 periprosthetic fractures. Afterwards, the osteotomies were fixed using the locking compression plate in combination with the locking attachment plate (LCP, LAP, DePuy Synthes, Solothurn, Switzerland)-group I. Group II additionally achieved a 5-hole 4.5/5.0 mm LCP anteriorly. Each construct was cyclically loaded to failure in axial compression. Axial construct stiffness was 50.87 N/mm (SD 1.61) for group I compared to 738.68 N/mm (SD 94.8) for group II, this difference was statistically significant (p = 0.016). The number of cycles to failure was also significant higher for group II (2,375 vs. 13,000 cycles; p = 0.016). Double plating can significantly increase construct stiffness and stability, and thus, is an option in the treatment of complex periprosthetic fractures, in revision surgery and for patients with the inability to partial weight bear. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:234-239, 2017.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Wähnert
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Grüneweller
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Dominic
authors.initials: D
authors.lastname: Gehweiler
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brunn
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Raschke
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149, Muenster, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Stange
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*
keywords: Vancouver B1 fracture; biomechanics; fixation double plate; periprosthetic