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Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Osteosynthesis of periprosthetic femoral fractures around hip arthroplasties is challenging, and locking plate fixation has been found to be a reasonable treatment. However, there is a paucity of evidence of the extent to which patients recover their activities of daily living (ADL). The purpose of this study was to study the clinical results, particularly recovery of ADL, radiological results, and potential complications arising from the use of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties.

Methods

We conducted a retrospective, multi-center study. Patients with periprosthetic femoral fractures around hip arthroplasties who were treated by osteosynthesis with use of locking plates and who underwent follow-up for at least 6 months postoperatively were enrolled in the study. For each patient, recovery of ADL, in terms of social and ambulatory recovery and Parker mobility score, were compared before fracture and at last follow-up. Postoperative complications were investigated. Bony union, loss of reduction, and malunion were assessed radiologically.

Results

Thirty-two patients were enrolled in this study. Mean follow-up was 25.1 months. For 84.4, 68.8, and 53.1 % of patients, respectively, social status, ambulation, and Parker mobility score at last follow-up were determined to be equal to that before the fracture. Bony union was observed for 30 patients within the follow-up period. Four patients had not achieved bony union 6 months postoperatively. There was no loss of reduction, malunion, or implant breakage, and no infection. For one patient each, partial pullout of the locking screws and a supracondylar fracture at the plate end were observed, and additional surgery was required.

Conclusions

Our results reveal that locking plate fixation provided sufficient stability for satisfactory recovery of ADL for most elderly patients with periprosthetic femoral fractures around hip arthroplasties.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Takahiro Niikura, Sang Yang Lee & Masahiro Kurosaka

  2. Department of Orthopaedic Surgery, Awaji Medical Center, Sumoto, Japan

    Atsushi Sakurai & Keisuke Oe

  3. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, Kobe, Japan

    Nao Shibanuma

  4. Department of Orthopaedic Surgery, Sanda Municipal Hospital, Sanda, Japan

    Masaya Tsunoda

  5. Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan

    Akihiro Maruo

  6. Department of Orthopaedic Surgery, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan

    Etsuo Shoda

  7. Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Yoshitada Sakai

Authors
  1. Takahiro Niikura
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  2. Atsushi Sakurai
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  3. Keisuke Oe
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  4. Nao Shibanuma
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  5. Masaya Tsunoda
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  6. Akihiro Maruo
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  7. Etsuo Shoda
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  8. Sang Yang Lee
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  9. Yoshitada Sakai
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  10. Masahiro Kurosaka
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Correspondence to Takahiro Niikura.

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Niikura, T., Sakurai, A., Oe, K. et al. Clinical and radiological results of locking plate fixation for periprosthetic femoral fractures around hip arthroplasties: a retrospective multi-center study. J Orthop Sci 19, 984–990 (2014). https://doi.org/10.1007/s00776-014-0622-3

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  • DOI: https://doi.org/10.1007/s00776-014-0622-3

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