Periprosthetic fracture around a stable femoral stem treated with locking plate osteosynthesis: distal femoral locking plate alone versus with cerclage cable
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To promote rapid bone healing, an adequate stable fixation implant with a percutaneous reduction instrument should be used for Vancouver type B1 or C fractures. The objective of this study was to describe radiographic and clinical outcomes of patients with periprosthetic fracture (PPF) around a stable femoral stem, treated with a distal femoral locking plate alone or with a cerclage cable. A total of 21 patients with PPF amenable to either a reverse distal femoral locking plate (LCP DF®) alone or with a cerclage cable, with a mean age of 75.7 years, were included. In these patients, ten fractures were treated with a reverse LCP DF® alone and were classified as group I, and 11 additionally received a cerclage cable and were classified as group II. Group II had a significantly longer operation time (P = 0.019) than group I and included one patient with nonunion at the final 24-month follow-up visit after the initial fracture reduction. However, this difference in nonunion rate for the two groups is more likely to inappropriate indications than surgical techniques. When comparing the stability of the fractures in both groups, there was no statistically significant difference, which might be attributed to the stable fixed-angle implant.
KeywordsPeriprosthetic fracture Distal femoral locking plate Cerclage cable Minimally invasive plate osteosynthesis Total hip arthroplasty
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article, nor have any funds been received in support of this study.
Compliance with ethical standards
Conflict of interest
The authors declare that we have no conflict of interest related to the publication of this manuscript.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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