Extracortical plate fixation with new plate inserts and cerclage wires for the treatment of periprosthetic hip fractures

Bastian, Johannes Dominik; Butscher, Andre; Bigolin, Gianni; Zumstein, Matthias; Nötzli, Hubert P (2014). Extracortical plate fixation with new plate inserts and cerclage wires for the treatment of periprosthetic hip fractures. International orthopaedics, 38(3), pp. 489-494. Springer 10.1007/s00264-013-2114-z

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PURPOSE Fixation of periprosthetic hip fractures with intracortical anchorage might not be feasible in cases with bulky implants and/or poor bone stock. METHODS Rotational stability of new plate inserts with extracortical anchorage for cerclage fixation was measured and compared to the stability found using a standard technique in a biomechanical setup using a torsion testing machine. In a synthetic PUR bone model, transverse fractures were fixed distally using screws and proximally by wire cerclages attached to the plates using "new" (extracortical anchorage) or "standard" (intracortical anchorage) plate inserts. Time to fracture consolidation and complications were assessed in a consecutive series of 18 patients (18 female; mean age 81 years, range 55-92) with periprosthetic hip fractures (ten type B1, eight type C-Vancouver) treated with the new device between July 2003 and July 2010. RESULTS The "new" device showed a higher rotational stability than the "standard" technique (p < 0.001). Fractures showed radiographic consolidation after 14 ± 5 weeks (mean ± SD) postoperatively in patients. Revision surgery was necessary in four patients, unrelated to the new technique. CONCLUSION In periprosthetic hip fractures in which fixation with intracortical anchorage using conventional means might be difficult due to bulky revision stems and/or poor bone stock, the new device may be an addition to the range of existing implants.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Bastian, Johannes Dominik and Zumstein, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0341-2695

Publisher:

Springer

Language:

English

Submitter:

Stephanie Schmutz

Date Deposited:

07 Mar 2014 03:27

Last Modified:

05 Oct 2015 09:00

Publisher DOI:

10.1007/s00264-013-2114-z

PubMed ID:

24091416

BORIS DOI:

10.7892/boris.43501

URI:

https://boris.unibe.ch/id/eprint/43501

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