Locking plate fixation with fibular allograft augmentation for failed peritrochanteric fractures: A technical note

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Bone Grafting Techniques

Background:

• Peritrochanteric fractures can fail due to poor bone stock.
• Fibular allograft (FA) has shown success in proximal humeral fractures.
• A need exists for effective fixation in complex peritrochanteric fractures with compromised bone quality.

Purpose of the Study:

• To evaluate the efficacy of fibular allograft (FA) combined with a locking plate for treating nonunion of peritrochanteric fractures.
• To assess bone union rates, time to union, and postoperative complications in patients with poor bone stock.

Main Methods:

• A retrospective study of ten patients with nonunion of peritrochanteric fractures and poor bone stock.
• Treatment involved fixation with fibular allograft (FA) and a locking plate.
• Analysis of bone union status, union duration, and complications.

Main Results:

• Complete bone union was achieved in all ten patients.
• The average time to bone union was 9.6 months (range 6-14 months).
• No complications related to the fibular allograft, such as infection, were observed.

Conclusions:

• Fibular allograft (FA) in conjunction with a locking plate is a successful fixation strategy for nonunion of peritrochanteric fractures in patients with poor bone stock or cortical defects.
• This technique offers a viable solution for challenging fracture cases.
• Further long-term studies are recommended for comprehensive validation.