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Isolated locked compression plating for Vancouver Type B1 periprosthetic femoral fractures
Ginger K Bryant1, Saam Morshed, Julie Agel
1Department of Orthopaedics and Sports Medicine, Harborview Medical Centre, University of Washington, Seattle, WA 98104, USA.
Objective:
Report treatment results of periprosthetic femoral fractures adjacent or at the tip of a stable femoral stem (Vancouver Type B1) using a locked compression plate as the sole method of fracture stabilisation.
Design:
Retrospective case series.
Setting:
Academic Level I Trauma Centre.
Patients:
Patients operatively treated at our institution with locked compression plating for Vancouver Type B1 periprosthetic fractures between 2002 and 2006 with at least 12 weeks of clinical follow-up were included. Patient demographics, hip arthroplasty implant characteristics, and AO/OTA fracture type were recorded.
Intervention:
Open reduction internal fixation using a locked-plate spanning a majority of the femur through a lateral soft-tissue sparing approach. No cortical onlay allografts or cerclage devices (wires or cables) were used.
Main Outcome Measurements:
Clinical union was defined at a minimum of 12 weeks as ability to walk, with or without the use of a walking aide, without pain at or around the fracture site. Radiographic union was defined by bridging bone spanning two or more cortices on orthogonal radiographs of the femur.
Results:
Ten subjects met the inclusion criteria and were followed for a mean of 27 weeks (range 14-97 weeks). All achieved fracture union at a mean of 17 weeks (range 12-27 weeks). There were no hardware failures or changes in fracture alignment from operative radiographs. There were no major complications that necessitated reoperation.
Conclusions:
Open reduction internal fixation of Vancouver Type B1 periprosthetic femoral fractures using a lateral locked-plate that spans the full extent of the femur as the sole method of stabilisation is a successful treatment method that minimises soft-tissue dissection and provides adequate fixation strength to maintain fracture alignment to fracture union.
