Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur—A prospective study of 41 patients

Ruchholtz, Steffen; El-Zayat, Bilal Farouk; Kreslo, D.; Bücking, Benjamin; Lewan, Ulrike; Krüger, Antonio; Zettl, Ralph

doi:10.1016/j.injury.2012.10.035

Cited by 55 publications

(48 citation statements)

References 33 publications

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“…This newly designed second generation plate system has shown promising results so far [20]; however, it has not been evaluated biomechanically in a periprosthetic fracture situation yet. Compared to the first model for distal femur application, there are now three variants of the plate for proximal, diaphyseal and distal femur fractures.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

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Purpose Fractures of the femur associated with total hip arthroplasty are a significant concern in orthopaedic and trauma surgery. However, little is known about the different biomechanical properties of internal fixation systems in combination with periprosthetic fractures. In this study two new internal fixation systems for periprosthetic fractures are investigated using a cadaver fracture model simulating a Vancouver B1 periprosthetic femur fracture. Methods Nine pairs of fresh-frozen cadaver femurs were scanned by dual X-ray absorptiometry. Cementless total hip prostheses were implanted and a periprosthetic femur fracture was simulated. Fractures were randomly fixed either with the fixed angle locking attachment plate (LAP®, Depuy Synthes®, Solothurn, Switzerland) or the variable angle noncontact bridging plate (NCB®, Zimmer GmbH, Winterthur, Switzerland). Each construct was cyclically loaded to failure in axial compression. Results Axial stiffness and cycles to failure were significantly higher in the NCB group. Both systems were able to be fixed well around the femoral stem. Conclusion The two different internal fixation systems for periprosthetic fractures differed significantly in our setup. The non-contact bridging plate system revealed significantly higher failure load and may be the preferred option where high stability and load capacity is needed right after operation.

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Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Wähnert

Schröder

Schulze

et al. 2013

International Orthopaedics (SICOT)

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“…Due to its extramedullary design, especially locking plate osteosynthesis induces some interfragmentary motion at the cortex opposite to the plate, while motion is reduced at the cortex adjacent to the plate [6]. The opportunity for minimally invasive implantation of a plate, which would lead to lower rates of soft tissue complications, could additionally improve the healing process [32]. Nevertheless, when fracture strain exceeds the healing threshold, evidence exists from biomechanical and animal studies that bone healing can be disturbed, leading to nonunion, malunions or implant failure [4,15].…”

Section: Load In Newton (N) Deformation In Milimeter (Mm)mentioning

confidence: 99%

“…In addition to improved stability, anglestable plate systems also offer the possibility of soft tissue protection and indirect fracture repositioning by plate insertion through a minimally invasive approach [32].…”

Section: Introductionmentioning

confidence: 99%

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Bliemel

Buecking

Mueller

et al. 2014

Arch Orthop Trauma Surg

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Based on our results, no statements regarding the superiority of either of the devices can be made. Even though the load to failure values for both osteosyntheses were much higher than the loads experienced during normal walking; however, because only axial loading was applied, it remains unclear whether both osteosyntheses meet the estimated requirements for postoperative full weight-bearing for an average heavy patient with a distal femoral fracture.

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“…In the literature, the mechanical advantage of multidirectional screws is controversial concerning the distal femur [32,33] but has been proven for PPF [14]. The clinical advantage has been stressed, but some authors [21] have experienced better and more encouraging clinical results with a minimally invasive approach than with a mini-open approach [34]. Most manufacturers allow a 30°cone (15°in each direction), though the optimal cone to avoid harming assembly stability is around 20°(10°in each direction) [35].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

Ehlinger

Scheibling

Rahmé

et al. 2015

International Orthopaedics (SICOT)

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Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur—A prospective study of 41 patients

Cited by 55 publications

References 33 publications

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Biomechanical comparison of two angular stable plate constructions for periprosthetic femur fracture fixation

Distal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model

Minimally invasive surgery with locking plate for periprosthetic femoral fractures: technical note

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