Implants with multidirectional locked screws have theoretical advantages in the treatment of periprosthetic fractures. In osteoporotic bone those locked plate systems with multidirectional applicable screws give a high stability. With the possibility of fixing screws in various angles, a rigid fixation in the presence of a prosthetic implant can be achieved. We concluded a retrospective study of a consecutive series of the outcome of Vancouver B1 and C femoral injuries using two specific locked implants (Straight and wave plate). From June 1996 to December 2004 we treated 58 patients with a periprosthetic fracture of the femur with a locked plate. The mean age at the index procedure was 72.4 years, 40 patients were female (69%). In 32 cases (55.2%) we saw a hip endoprosthesis, in 21 cases (36.2%) a knee endoprosthesis and in 5 cases both (8.6%). Outcome measures were intra- and postoperative complications, bony union, degree of mobility and social status, Barthel mobility index and “stand up and go” test. Union occurred in 56 cases (96.5%) after the index procedure. Twice the implant failed, we saw 4 general complications. The mean duration until full weight bearing status in these patients was 8.6 weeks. At follow up 46 patients (78%) had maintained the same social status as before the fracture. Regarding the mobility status 52 patients (89%) had regained their previous level, 4 patients walking without aid before now required a cane and two patients a walking frame. The mean Barthel Index was 85 points of possible 100 and improved from 35 points at point of beginning of the rehabilitation. The mean stand-up&
go time was measured as 22 seconds.
