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Clinical and radiological results of patients treated with orthogonal double plating for periprosthetic femoral fractures

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Abstract

Purpose

The aim of this study was to determine the outcome of surgically-treated periprosthetic femoral fractures with an orthogonal double plate system.

Methods

We performed a retrospective study of ten patients (mean age 79.5 years) surgically treated for periprosthetic femoral fractures using orthogonal double plating (lateral and additional anterior plate position) from 2010 to 2013. The patients’ demographic characteristics, complications and initial follow-up data were retrieved from our institutional database. After a minimum of six months post-surgery, we performed a radiological and clinical follow-up.

Results

The surgical indications for orthogonal plating were heterogenic; five patients were treated for periprosthetic fractures around their total hip prosthesis. One was treated for a fracture around a total knee prosthesis and one for an interprosthetic fracture. Additionally, three patients were treated for postoperative implant failure after the stabilisation of periprosthetic fractures around a total hip prosthesis (one) or total knee prosthesis (two). Osteosynthesis was performed using locking compression plates exclusively (length between eight and 20 holes). After a mean follow-up of 22.6 months (range, six to 42 months), two patients died, but their deaths were due to old age morbidity and were unrelated to the surgery. Surgical revision for implant failure was necessary for only one female patient due to a breakage of the lateral plate. In addition, no other failures, such as infection or non-union, were observed. At the time of follow-up, seven out of ten patients were mobile and subjectively satisfied in regards to their outcome.

Conclusions

Based on a small number of cases, we were able to show for the first time that the use of orthogonal double plating is not associated with an increased rate of complications in patients with periprosthetic femoral fractures and stable components. Moreover, orthogonal double plating can be used successfully as a salvage procedure. At the time of follow up, seven out of ten patients were mobile. More cases must be investigated to validate our findings.

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Conflicts of interest

No outside funding was received in support of this research or in the preparation of this article. Neither author has received financial or any other support relevant to the implant used in this study or in this study’s preparation. The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Clinic for Trauma, Orthopaedics and Sports Medicine, Hospital Barmherzige Brüder, 93049, Regensburg, Germany

    Franz Josef Müller, Michael Galler & Bernd Füchtmeier

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  1. Franz Josef Müller
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  2. Michael Galler
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  3. Bernd Füchtmeier
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Correspondence to Franz Josef Müller.

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Müller, F.J., Galler, M. & Füchtmeier, B. Clinical and radiological results of patients treated with orthogonal double plating for periprosthetic femoral fractures. International Orthopaedics (SICOT) 38, 2469–2472 (2014). https://doi.org/10.1007/s00264-014-2464-1

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  • DOI: https://doi.org/10.1007/s00264-014-2464-1

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