Are proximal screws necessary for osteosynthesis of stable-stem periprosthetic femoral fractures fixed with non-locking plate and cable?
| Autor: | Ming Chau Chang, Chao Ching Chiang, Chien Shun Wang, Chun Cheng Lin, Tzu Cheng Yang, Yun Hsuan Tzeng |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Bone Screws Group ii Dynamic compression plate Periprosthetic Locking plate Fracture Fixation Internal 03 medical and health sciences Fixation (surgical) 0302 clinical medicine medicine Humans Stem subsidence Aged Retrospective Studies General Environmental Science Aged 80 and over Fracture Healing 030222 orthopedics Osteosynthesis business.industry 030208 emergency & critical care medicine Surgery Radiography Treatment Outcome Harris Hip Score General Earth and Planetary Sciences Female Periprosthetic Fractures business Bone Plates Femoral Fractures |
| Zdroj: | Injury. 50:1739-1744 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2019.06.009 |
| Popis: | Introduction The purpose of this study was to assess the effectiveness of the cable-plate-cable technique which comprises fixation of the proximal fragment using cable loops without additional proximal screws on the plate for the treatment of stable-stem periprosthetic femoral fractures around hip prostheses. Methods We retrospectively reviewed Vancouver types B1 and C periprosthetic femoral fractures treated with a dynamic compression plate combined with Dall-Miles cable between 2010 and 2016 at a single institution and followed for at least 12 months. Patients were treated with proximal fragment fixation using cable combined with screws (Group I) or with proximal fragment fixation using cable alone (Group II). Demographic data, fracture types, and clinical and radiological outcomes were analyzed. Results A total of 50 patients were included (Group I, n = 23 patients; Group II, n = 27). Fracture union was achieved in 49 patients with one case of non-union in Group I and no cases of non-union in Group II. Mean time to union was 5.4 months in Group I and 5.1 months in Group II (P = 0.624). Mean Harris hip score at latest assessment was 69.5 in Group I and 69.4 in Group II (P = 0.919). Regarding complications, there was one deep wound infection, one stem subsidence, and one loss of reduction in Group I, and one stem subsidence in Group II. No significant difference in clinical and radiological outcomes between groups was observed. Conclusions The cable-plate-cable technique sufficiently treats Vancouver types B1 and C periprosthetic femoral fractures without use of additional screws in the proximal fragment. |
| Databáze: | OpenAIRE |
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