A Lunebourg1, E Mouhsine2, S Cherix3, M Ollivier4, F Chevalley3, M Wettstein2. 1. Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland; Service de chirurgie orthopédique et traumatologie, institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address: alexandre.lunebourg@gmail.com. 2. Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland; ITOLS, clinique de Genolier, 3, route de Muids, 1272 Genolier, Switzerland. 3. Service de chirurgie orthopédique et traumatologie, département appareil-locomoteur, centre universitaire hospitalier vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Switzerland. 4. Service de chirurgie orthopédique et traumatologie, institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
Abstract
INTRODUCTION: Periprosthetic femur fracture (PFF) is a serious complication after total hip arthroplasty that can be treated using different internal fixation devices. However, the outcomes with curved non-locking plates with eccentric holes in this indication have not been reported previously. The objectives of this study were to determine: (1) the union rate; (2) the complication rate; (3) autonomy in a group of patients with a Vancouver type B PFF who were treated with this plate. HYPOTHESIS: Use of this plate results in a high union rate with minimal mechanical complications. MATERIALS AND METHODS: Forty-three patients with a mean age of 79 years ± 13 (41-98) who had undergone fixation of Vancouver type B PFF with this plate between 2002 and 2007 were included in the study. The time to union and Parker Mobility Score were evaluated. The revision-free survival (all causes) was calculated using Kaplan-Meier analysis. The average follow-up was 42 months ± 20 (16-90). RESULTS: Union was obtained in all patients in a mean of 2.4 months ± 0.6 (2-4). One patient had varus malunion of the femur. The Parker Mobility Score decreased from 5.93 ± 1.94 (2-9) to 4.93 ± 1.8 (1-9) (P = 0.01). Two patients required a surgical revision: one for an infection after 4.5 years and one for stem loosening. The survival of the femoral stem 5 years after fracture fixation was 83.3% ± 12.6%. CONCLUSION: Use of a curved plate with eccentric holes for treating type B PFF led to a high union rate and a low number of fixation-related complications. However, PFF remains a serious complication of hip arthroplasty that is accompanied by high morbidity and mortality rates.
INTRODUCTION: Periprosthetic femur fracture (PFF) is a serious complication after total hip arthroplasty that can be treated using different internal fixation devices. However, the outcomes with curved non-locking plates with eccentric holes in this indication have not been reported previously. The objectives of this study were to determine: (1) the union rate; (2) the complication rate; (3) autonomy in a group of patients with a Vancouver type B PFF who were treated with this plate. HYPOTHESIS: Use of this plate results in a high union rate with minimal mechanical complications. MATERIALS AND METHODS: Forty-three patients with a mean age of 79 years ± 13 (41-98) who had undergone fixation of Vancouver type B PFF with this plate between 2002 and 2007 were included in the study. The time to union and Parker Mobility Score were evaluated. The revision-free survival (all causes) was calculated using Kaplan-Meier analysis. The average follow-up was 42 months ± 20 (16-90). RESULTS: Union was obtained in all patients in a mean of 2.4 months ± 0.6 (2-4). One patient had varus malunion of the femur. The Parker Mobility Score decreased from 5.93 ± 1.94 (2-9) to 4.93 ± 1.8 (1-9) (P = 0.01). Two patients required a surgical revision: one for an infection after 4.5 years and one for stem loosening. The survival of the femoral stem 5 years after fracture fixation was 83.3% ± 12.6%. CONCLUSION: Use of a curved plate with eccentric holes for treating type B PFF led to a high union rate and a low number of fixation-related complications. However, PFF remains a serious complication of hip arthroplasty that is accompanied by high morbidity and mortality rates.
Authors: David González-Martín; José Luis Pais-Brito; Sergio González-Casamayor; Ayron Guerra-Ferraz; Jorge Ojeda-Jiménez; Mario Herrera-Pérez Journal: EFORT Open Rev Date: 2022-08-04
Authors: Karl Stoffel; Michael Blauth; Alexander Joeris; Andrea Blumenthal; Elke Rometsch Journal: Arch Orthop Trauma Surg Date: 2020-02-21 Impact factor: 3.067