Reversed anatomic distal femur locking plate for periprosthetic hip fracture fixation

Abstract

The incidence of femoral fracture on hip prosthesis is increasing. Plate fixation is the method of choice when the prosthesis is stable. In fracture with proximal extension, the quality of the bone fixation is critical and, despite the development of anatomic plates, may be endangered when there are too few proximal screws. To resolve this issue, we recommend using a reversed LCP™ anatomic distal femoral Less Invasive Stabilization System (LISS™) locking plate: e.g., a left distal femoral plate for femoral fracture on right-hip implant. This presents several advantages: minimally invasive surgery, the introduction of the plate being facilitated by the LISS™ ancillary; ease of locking, also thanks to the ancillary; and, above all, multiple proximal trochanteric fixation thanks to the form of this anatomic distal LISS™ plate, improving proximal bone fixation. The present technical note seeks to illustrate the interest of using a "reversed" plate, in terms of simplicity of fitting and quality of reduction and consolidation, while also specifying the associated limitations and tolerance.

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]:…”

“…Only one model is currently used: the Less Invasive Stabilisation System (LISS) distal femoral plate. Available in different lengths (5-23 holes), it can be used normally or inverted (a right plate for a left proximal femur) [7]. These different lengths are important, allowing stabilisation of the entire femur.…”

Fixation of Subtrochantric Fractures Using Distal Femoral Locking Compression Plate of Contralateral Side

“…We therefore recommend using the Distal Femoral LCP (locking compression plate) in a reversed situation: e.g., right plate for left hip. The aim is to enhance trochanteric fixation by increasing the number of proximal screws [5] .…”

EDITORIAL : Plating Other than Where They Are Designed to Be Placed

“…And we can use distal femoral plate for proximal femur fracture. 2,3) In one paper, they reported the adequacy of PHILOS plates for distal medial tibial fixation or ankle arthrodesis. 4) And plating of lateral clavicle plate for medial clavicle fracture was also reported.…”