Locking attachment plate fixation around a well-fixed stem in periprosthetic femoral shaft fractures

Min Bom Kim, Jae Woo Cho, Young Ho Lee, Won Yong Shon, Jung Wee Park, Jinil Kim, Jong-Keon Oh

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture. Materials and methods: Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014. Patients were followed up for at least 1 year postoperatively. Median age was 74 years (range 56–96 years). Fractures were classified according to the Unified Classification System, Vancouver classification, and Su classification. Procedure: Open reduction was performed under minimal incision and the locking plate was fixed to the lateral cortex of the femoral shaft. The part of the shaft without a stem was fixed to the plate using 5.0-mm locking screws, and the part with an underlying stem was fixed using 3.5-mm locking screws through the LAP instead of cables. Postoperatively, patients were managed using general principles for femoral shaft fractures. Results: Average follow-up was 16 months (range 12–36 months). All cases achieved fracture healing without loss of reduction. There were no cases of implant breakage or stem loosening at final follow-up. The average number of LAPs per fixation construct was 2.1 (range 1–4), and the average number of 3.5-mm locking screws through each LAP was 3.3 (range 2–4). The average value of plate screw density was 0.55 (range 0.37–0.8), and the average working length was four holes (range 2–8). Conclusions: Using the LAP to manage periprosthetic fractures with a well-fixed stem could obviate the need for cable around the stem area and yield acceptable outcomes.

Original languageEnglish
Pages (from-to)1193-1200
Number of pages8
JournalArchives of Orthopaedic and Trauma Surgery
Volume137
Issue number9
DOIs
Publication statusPublished - 2017 Sep 1

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Periprosthetic Fractures
Femoral Fractures
Fracture Healing
Thigh
Bone and Bones

Keywords

  • Locking attachment plate
  • Periprosthetic femoral fractures
  • Plate screw density
  • Well-fixed stem

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Locking attachment plate fixation around a well-fixed stem in periprosthetic femoral shaft fractures. / Kim, Min Bom; Cho, Jae Woo; Lee, Young Ho; Shon, Won Yong; Park, Jung Wee; Kim, Jinil; Oh, Jong-Keon.

In: Archives of Orthopaedic and Trauma Surgery, Vol. 137, No. 9, 01.09.2017, p. 1193-1200.

Research output: Contribution to journalArticle

Kim, Min Bom ; Cho, Jae Woo ; Lee, Young Ho ; Shon, Won Yong ; Park, Jung Wee ; Kim, Jinil ; Oh, Jong-Keon. / Locking attachment plate fixation around a well-fixed stem in periprosthetic femoral shaft fractures. In: Archives of Orthopaedic and Trauma Surgery. 2017 ; Vol. 137, No. 9. pp. 1193-1200.
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abstract = "Introduction: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture. Materials and methods: Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014. Patients were followed up for at least 1 year postoperatively. Median age was 74 years (range 56–96 years). Fractures were classified according to the Unified Classification System, Vancouver classification, and Su classification. Procedure: Open reduction was performed under minimal incision and the locking plate was fixed to the lateral cortex of the femoral shaft. The part of the shaft without a stem was fixed to the plate using 5.0-mm locking screws, and the part with an underlying stem was fixed using 3.5-mm locking screws through the LAP instead of cables. Postoperatively, patients were managed using general principles for femoral shaft fractures. Results: Average follow-up was 16 months (range 12–36 months). All cases achieved fracture healing without loss of reduction. There were no cases of implant breakage or stem loosening at final follow-up. The average number of LAPs per fixation construct was 2.1 (range 1–4), and the average number of 3.5-mm locking screws through each LAP was 3.3 (range 2–4). The average value of plate screw density was 0.55 (range 0.37–0.8), and the average working length was four holes (range 2–8). Conclusions: Using the LAP to manage periprosthetic fractures with a well-fixed stem could obviate the need for cable around the stem area and yield acceptable outcomes.",
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AU - Kim, Min Bom

AU - Cho, Jae Woo

AU - Lee, Young Ho

AU - Shon, Won Yong

AU - Park, Jung Wee

AU - Kim, Jinil

AU - Oh, Jong-Keon

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AB - Introduction: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture. Materials and methods: Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014. Patients were followed up for at least 1 year postoperatively. Median age was 74 years (range 56–96 years). Fractures were classified according to the Unified Classification System, Vancouver classification, and Su classification. Procedure: Open reduction was performed under minimal incision and the locking plate was fixed to the lateral cortex of the femoral shaft. The part of the shaft without a stem was fixed to the plate using 5.0-mm locking screws, and the part with an underlying stem was fixed using 3.5-mm locking screws through the LAP instead of cables. Postoperatively, patients were managed using general principles for femoral shaft fractures. Results: Average follow-up was 16 months (range 12–36 months). All cases achieved fracture healing without loss of reduction. There were no cases of implant breakage or stem loosening at final follow-up. The average number of LAPs per fixation construct was 2.1 (range 1–4), and the average number of 3.5-mm locking screws through each LAP was 3.3 (range 2–4). The average value of plate screw density was 0.55 (range 0.37–0.8), and the average working length was four holes (range 2–8). Conclusions: Using the LAP to manage periprosthetic fractures with a well-fixed stem could obviate the need for cable around the stem area and yield acceptable outcomes.

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