PERIPROSTHETIC FRACTURES AROUND A STABLE FEMORAL STEM TREATED BY LOCKING PLATE OSTEOSYNTHESIS: DISTAL FEMORAL LOCKING PLATE ALONE VERSUS WITH CERCLAGE CABLE

Purpose

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.

Materials and Methods

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, 10 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.[Fig.1]

Results

Group I was not inferior to group II, as reflected by HHS evaluations. Additionally, 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.[Fig. 2]

Conclusion

Use of reverse LCP DF^® alone appears to provide advantages in the biological healing process compared with the use of reverse LCP DF^® with a cerclage cable. 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.

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