A Unique Mode of Failure in the Noncontact Bridging Periprosthetic Plating System

Abstract

Although lateral locking plates are often a preferred and successful fixation construct for the treatment of periprosthetic proximal and distal femur fractures, specific complications and modes of failure have been associated and well-described with their use. We present two cases of implant failure in the Non-Contact Bridge Periprosthetic Plating System (Zimmer Biomet) in which a nonlocked screw fretted through the annular seating of the plate. One case demonstrates failure in the setting of a proximal femur periprosthetic fracture, whereas the other demonstrates failure in the setting of a distal femur periprosthetic fracture. This unique mode of failure has not previously been reported in the literature.

Use of the Locking Attachment Plate for Internal Fixation of Periprosthetic Femur Fractures

“…12 A unique failure mode recently reported in a case study using Zimmer NCB plate was of a standard screw remaining in bone and then fretting through the annular seating of the plate. 13 Authors hypothesized that the use of standard screws made the construct too stiff and recommended using locking screws adjacent to the fracture site. 13 The Iron Lady ® Conical Coupling Locking Plate (Intrauma, Rivoli, Italy) is a new plate with a semitubular shape and triplanar locking screw placement that allows polyaxial screws to be placed around the femoral stem.…”

“…13 Authors hypothesized that the use of standard screws made the construct too stiff and recommended using locking screws adjacent to the fracture site. 13 The Iron Lady ® Conical Coupling Locking Plate (Intrauma, Rivoli, Italy) is a new plate with a semitubular shape and triplanar locking screw placement that allows polyaxial screws to be placed around the femoral stem. It was recently used in the treatment of Vancouver B1 PPFFx, reporting fracture healing in 29/32 (91%) patients by 6 months follow-up, which they claimed was consistent with recent literature using other polyaxial plates.…”