Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures
Introduction The locking attachment plate (LAP) can be added to a locking compression plate (LCP) to allow the fixation of locking screws bicortically around a femoral implant. We aimed to examine surgical and fracture characteristics associated with healing for periprosthetic femur fractures (PPFFx...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-04-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593221100417 |
| _version_ | 1828789984570638336 |
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| author | Bryce Wall MD Jeffrey B Stambough MD Steven M. Cherney MD Simon C Mears MD, PhD |
| author_facet | Bryce Wall MD Jeffrey B Stambough MD Steven M. Cherney MD Simon C Mears MD, PhD |
| author_sort | Bryce Wall MD |
| collection | DOAJ |
| description | Introduction The locking attachment plate (LAP) can be added to a locking compression plate (LCP) to allow the fixation of locking screws bicortically around a femoral implant. We aimed to examine surgical and fracture characteristics associated with healing for periprosthetic femur fractures (PPFFx) treated with constructs employing LAP fixation. We hypothesize that the addition of an LAP provides stable peri-implant fixation. Materials &Methods We retrospectively reviewed a consecutive series of 28 PPFFx surgically treated with LCP-LAP constructs by 4 surgeons from 2015-2020. Fractures were classified and grouped using the Vancouver Classification System and included 12 B1, 2 B2, 11 C fractures, and 3 fractures around other stemmed implants. Primary outcome measures included hardware failure such as screw pullout, broken screws, and plate fracture. Clinical complications including infection, non-union, malunion, and reoperation were recorded. Results No LAP failures, screw pullout, or broken screws were observed. Two fractured plates (7.1%) occurred in patients with Vancouver C fracture types. Overall complication rate was 17.9% and included 3 non-unions, 1 deep infection, and 1 implant loosening with painful hardware, each requiring reoperation. Differences were observed between unions and nonunions for total number of screws (12.4 vs 14.7, P = .005) and number of locking screws used (8.04 vs 11.3, P = .03). Conclusion The LAP provides adequate fixation and low failure rates where fixation is required around a well-fixed stem. When failures occur, it is from plate breakage and not due to failure of fixation at the area of plate-stem overlap. |
| first_indexed | 2024-12-12T01:21:34Z |
| format | Article |
| id | doaj.art-d2e9ad9cc42d476cac1c82def395dfed |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-12-12T01:21:34Z |
| publishDate | 2022-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-d2e9ad9cc42d476cac1c82def395dfed2022-12-22T00:43:13ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932022-04-011310.1177/21514593221100417Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur FracturesBryce Wall MDJeffrey B Stambough MDSteven M. Cherney MDSimon C Mears MD, PhDIntroduction The locking attachment plate (LAP) can be added to a locking compression plate (LCP) to allow the fixation of locking screws bicortically around a femoral implant. We aimed to examine surgical and fracture characteristics associated with healing for periprosthetic femur fractures (PPFFx) treated with constructs employing LAP fixation. We hypothesize that the addition of an LAP provides stable peri-implant fixation. Materials &Methods We retrospectively reviewed a consecutive series of 28 PPFFx surgically treated with LCP-LAP constructs by 4 surgeons from 2015-2020. Fractures were classified and grouped using the Vancouver Classification System and included 12 B1, 2 B2, 11 C fractures, and 3 fractures around other stemmed implants. Primary outcome measures included hardware failure such as screw pullout, broken screws, and plate fracture. Clinical complications including infection, non-union, malunion, and reoperation were recorded. Results No LAP failures, screw pullout, or broken screws were observed. Two fractured plates (7.1%) occurred in patients with Vancouver C fracture types. Overall complication rate was 17.9% and included 3 non-unions, 1 deep infection, and 1 implant loosening with painful hardware, each requiring reoperation. Differences were observed between unions and nonunions for total number of screws (12.4 vs 14.7, P = .005) and number of locking screws used (8.04 vs 11.3, P = .03). Conclusion The LAP provides adequate fixation and low failure rates where fixation is required around a well-fixed stem. When failures occur, it is from plate breakage and not due to failure of fixation at the area of plate-stem overlap.https://doi.org/10.1177/21514593221100417 |
| spellingShingle | Bryce Wall MD Jeffrey B Stambough MD Steven M. Cherney MD Simon C Mears MD, PhD Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures |
| title_full | Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures |
| title_fullStr | Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures |
| title_full_unstemmed | Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures |
| title_short | Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures |
| title_sort | use of the locking attachment plate for internal fixation of periprosthetic femur fractures |
| url | https://doi.org/10.1177/21514593221100417 |
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