Periprosthetic femoral fractures treated by locked plating: Feasibility assessment of the mini-invasive surgical option. A prospective series of 36 fractures

Abstract

Locking compression plates associated with a mini-invasive surgical approach result in a high rate of union (35/36) with no significant misalignment (only 5/36 cases of misalignment of more than 5°), no refractures (n=0) and a low rate of mechanical failure (3/36) while allowing full weight bearing in most cases (20/36). Locking plates for periprosthetic femoral fractures allow patients to begin walking again, with stable intermediate term results.

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

“…These mechanical properties are essential in this often aged population with poor bone quality. The technique we describe has good radiological and clinical results [5][6][7], comparable with those in the literature, for both hip [19][20][21] or knee [21][22][23]. Locking plates are considered the most adapted and universal treatment [21], having less complications on TKA fractures compared with regular plates [24].…”

“…In daily practice, we allow total weight bearing postoperatively as often as possible in order to preserve patient autonomy and decrease bedsore complications [5][6][7]. However, our experience confirms that implant assembly must follow certain guidelines [7,9,10]:…”

“…In our experience, the use of titanium makes for better elasticity, which is beneficial to consolidation [5][6][7] but can cause difficulty in material ablation. Literature is relatively scarce on the subject, but the few published studies emphasise the mechanical and biological advantages of titanium plates by proving that early weight bearing is possible and that their use favours faster union [36,37].…”

“…This surgery combines the mechanical stability and assembly of these plates with the advantages of closed-wound surgery, with preservation of fracture haematoma [2][3][4]. Strict adherence to certain guidelines allows immediate post-operative weight bearing [5,6].…”

Clinical Outcomes of Distal Femoral Fractures in the Geriatric Population Using Locking Plates With a Minimally Invasive Approach

“…1 A recent study has validated the clinical advantages of MIPO technique with locking plates in treatment of distal femur periprosthetic fractures. 13 In our study, there were no complications of infection, wound breakdown, or nonunion resulting from surgical approach, technique, and choice of implant. The complications seen in our population were urinary tract infection and pneumonia, which resolved with treatment.…”