The “Double Washer” Technique Is an Effective Strategy for Bicortical Fixation in Periprosthetic Fractures About a Femoral Stem: A Technical Trick and Case Series

Abstract

Periprosthetic fractures about the hip and knee are challenging injuries to treat for the orthopaedic surgeon. The preexisting femoral implant and poor bone quality provide for difficulties in achieving stable fixation. We present a surgical technique and clinical series of 5 patients describing the use and outcomes of a 3.5 screw with a "double washer" technique to achieve bicortical fixation around a femoral prosthesis.

Proximal tibia and tibial plateau nail-plate combinations: technical trick and case series

“…However, this is not strictly necessary, provided the plate is secured appropriately in the shaft. Additionally, there may be a size mismatch between the plate and a tibial nail screw, resulting in the inability to link constructs without using the smaller diameter screw with an extra washer, in a similar fashion as described previously for femur fractures [21] …”