AI Article Synopsis
- The study aims to identify prognostic factors influencing outcomes in treating periprosthetic femoral fractures using a cable-plate construct.
- A retrospective analysis of 41 femoral fractures showed a 70.7% healing rate, with significant predictors for success being fracture pattern, plate overlap percentage, and patients' preoperative bone density.
- Caution is advised when treating transverse fractures or patients with severe osteoporosis, emphasizing the importance of sufficient plate overlap to enhance healing success.
Article Abstract
Purpose: To analyze prognostic factors for the treatment of periprosthetic femoral fractures (PFFs) using the cable-plate construct.
Materials And Methods: A retrospective review of a consecutive series of 41 PFFs treated by osteosynthesis using the cable-plate system. The mean age of patients was 67.3±12.1 years (range, 42-86 years) and the mean follow-up period was 31.5±11.6 months (range, 12-58 months). Fresh frozen cortical strut allografts were leveraged in three cases for additional stability. Prognostic factors that may potentially affect clinical outcomes were analyzed.
Results: At the time of final follow-up, fracture union was obtained in 29 hips (70.7%; Group I) after an average of 13.5 weeks (range, 12-24 weeks). Healing failure after surgical treatment was observed in 12 cases (29.3%; Group II), including delayed union (n=10) cases and nonunion (n=2). Factors significantly associated with fracture union included fracture pattern (=0.040), plate overlap percentage to stem length (<0.001) and T-score at the preoperative bone mineral density (=0.011). Transverse-type fractures around or just distal to a well-fixed femoral stem were observed in six cases (50.0%) of Group II.
Conclusion: The cable-plate osteosynthesis of PFFs should be performed with caution in transverse-type fractures or in cases with severe osteoporosis. Fixation with sufficient plate overlap to stem length may be critical to prevent healing failure.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726864 | PMC |
| http://dx.doi.org/10.5371/hp.2019.31.3.166 | DOI Listing |
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