Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem

Dennis, Michael G.; Simon, Jordan A.; Kummer, Frederick J.; Koval, Kenneth J.; DiCesare, Paul

doi:10.1054/arth.2000.4339

Cited by 180 publications

(145 citation statements)

References 22 publications

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“…Numerous biomechanical studies investigated different techniques of periprosthetic fracture fixation [7][8][9][10][11][12], although as yet, not all types of these fractures or fixation methods have been comprehensively evaluated and new tools for fixation are on the way.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

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Purpose Fractures of the femur associated with total hip arthroplasty are a significant concern in orthopaedic and trauma surgery. However, little is known about the different biomechanical properties of internal fixation systems in combination with periprosthetic fractures. In this study two new internal fixation systems for periprosthetic fractures are investigated using a cadaver fracture model simulating a Vancouver B1 periprosthetic femur fracture. Methods Nine pairs of fresh-frozen cadaver femurs were scanned by dual X-ray absorptiometry. Cementless total hip prostheses were implanted and a periprosthetic femur fracture was simulated. Fractures were randomly fixed either with the fixed angle locking attachment plate (LAP®, Depuy Synthes®, Solothurn, Switzerland) or the variable angle noncontact bridging plate (NCB®, Zimmer GmbH, Winterthur, Switzerland). Each construct was cyclically loaded to failure in axial compression. Results Axial stiffness and cycles to failure were significantly higher in the NCB group. Both systems were able to be fixed well around the femoral stem. Conclusion The two different internal fixation systems for periprosthetic fractures differed significantly in our setup. The non-contact bridging plate system revealed significantly higher failure load and may be the preferred option where high stability and load capacity is needed right after operation.

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Section: Introductionmentioning

confidence: 99%

“…Various osteosynthetic devices have been developed over recent years to increase stability around the prosthesis [5,11,13]. New anatomically pre-shaped devices using angular stability may help to improve the outcome of those complicated fractures.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

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“…In a biomechanical study by Dennis et al (34), it was found that the system of plating with distal bicortical and proximal unicortical screws with or without a cable was biomechanically the most superior of the five systems studied.In another biomechanical study, Lever et al (35) compared the various fixation systems and found that the use of proximal unicortical and distal bicortical screws offered better stiffness and axial stability than use of cables in any instance.…”

Section: Discussionmentioning

confidence: 98%

Periprosthetic Fracture Treated With a Simple Technique: A Case Report

Kale¹,

Mahadik²

2013

jemds

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ABSTRACT:The advent and increasing use of joint replacement for various conditions has led to a new group of fractures-the periprosthetic fractures. The hip joint is commonly involved in this group. The management of these fractures is complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires.In General Hospital, health and economic problems of poor patients warrants a need for alternative simple technique for management of such cases.In this article we discuss a case of peri-prosthetic fracture of shaft of femur in a lean, short statured lady, reluctant for blood transfusion due to previous reaction secondary to minor incompatibility, treated by use of ender nail.CASE REPORT: 55 year female, lean and short statured lady, poorly nourished, from rural area, was brought to OPD with alleged history of fall about a day back with complaint of pain in left thigh and inability to bear weight and deformity. She underwent hemiarthroplasty (Austin moore prosthesis) for fracture neck femur on same side 2 years back.On examination, there was sub-trochanteric shortening of left lower limb with externally rotation, tenderness present over the junction of upper and middle third of thigh with swelling. Abnormal and painful mobility was elicited at that site.X-ray of pelvis including both hip joint and left thigh revealed peri-prosthetic fracture femur.Blood investigations revealed Hb 7.1. Other relevant investigations especially LFT, RFT were within normal limits. Due to respiratory and cardiac status, she was declared unfit for anaesthesia Intra-operative x-ray of peri-prosthetic fracture of left femur

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“…Authors have reported good results after treatment of Type B1 fractures with lateral plates without bone grafting [1,5,20], whereas others advocate the routine use of cortical strut allografts with or without plates [6,12], especially in the presence of medial cortex comminution [8]. Biomechanical analyses investigating optimal construct stiffness have led to varying recommendations of ideal constructs including: nonlocking cable plate and allograft [23], allograft-plate [22], and plate with proximal unicortical screws with or without cables and distal bicortical screws [9].…”

Section: Discussionmentioning

confidence: 99%

In Brief: Classifications in Brief: Vancouver Classification of Postoperative Periprosthetic Femur Fractures

Gaski

Scully

2011

Clinical Orthopaedics &Amp; Related Research

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Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem

Cited by 180 publications

References 22 publications

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Periprosthetic Fracture Treated With a Simple Technique: A Case Report

In Brief: Classifications in Brief: Vancouver Classification of Postoperative Periprosthetic Femur Fractures

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