The effect of fracture stability on the performance of locking plate fixation in periprosthetic femoral fractures

J Arthroplasty. 2013 Oct;28(9):1589-95. doi: 10.1016/j.arth.2013.03.022. Epub 2013 Apr 30.

Abstract

Periprosthetic femoral fracture (PFF) fixation failures are still occurring. The effect of fracture stability and loading on PFF fixation has not been investigated and this is crucial for optimum management of PFF. Models of stable and unstable PPFs were developed and used to quantify the effect of fracture stability and loading in a single locking plate fixation. Stress on the plate was higher in the unstable compared to the stable fixation. In the case of unstable fractures, it is possible for a single locking plate fixation to provide the required mechanical environment for callus formation without significant risk of plate fracture, provided partial weight bearing is followed. In cases where partial weight bearing is unlikely, additional biological fixation could be considered.

Keywords: finite element method; fracture movement; stiffness; strain; weight bearing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Bone Plates*
  • Femoral Fractures / physiopathology
  • Femoral Fractures / surgery*
  • Fracture Fixation, Internal / adverse effects*
  • Fracture Fixation, Internal / instrumentation
  • Humans
  • Models, Theoretical
  • Periprosthetic Fractures / physiopathology
  • Periprosthetic Fractures / surgery*
  • Stress, Mechanical
  • Weight-Bearing