Articles Vol. 66 No. 2 04/03/2025

46. OUTCOMES OF LOCKED PLATING WITH CABLES FOR PERIPROSTHETIC FEMORAL FRACTURES AROUND HIP STEM

Cao Thi1,2, Huynh Phuoc Hau3,4
1 University of Medicine and Pharmacy at Ho Chi Minh City
2 Đại học Y Dược TP. Hồ Chí Minh
3 Cho Ray Hospital
4 Bệnh viện Chợ Rẫy
Corresponding author: caothibacsi@ump.edu.vn
DOI: 10.52163/yhc.v66i2.2075
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Keywords
Periprosthetic femoral fracture locked plating cables hip arthroplasty bone healing
Abstract

Background: Periprosthetic femoral fractures around hip stems are complications following hip arthroplasty. They require stable fixation for early mobilization and optimal recovery. Locked plating with cables is an emerging technique that enhances stability in such fractures.

Objective: To evaluate the treatment outcomes of locked plating with cables in periprosthetic femoral fractures.

Methods: A retrospective study was conducted on 40 patients who underwent locked plating with cables for periprosthetic femoral fractures at Cho Ray Hospital from April 2020 to April 2024. Clinical and radiographic outcomes, including bone healing rates and functional hip scores, were assessed.

Results: The mean age of patients was 65.9 ± 19.8 years, with a male-to-female ratio of 1:1.2. The most common cause of fracture was living accident (80%). The average operative time was 142 minutes. Blood transfusion was required in 32 out of 40 cases (80%) due to significant intraoperative blood loss. At the 6-month follow-up, the bone healing rate was 95%, with a mean Harris Hip Score of 78.8. Complications included 2 cases of superficial infection (5%) and 2 cases of decubitus ulcer (5%).

Conclusion: Locked plating with cables provides stable fixation, allowing early mobilization and achieving high rates of bone healing. This technique is an effective option for treating periprosthetic femoral fractures.

References
[1]
Abdel MP, Watts CD, Houdek MT, Lewallen DG, Berry DJ. Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience. Bone Joint J. Apr 2016;98-b(4):461-7. doi:10.1302/0301-620x.98b4.3720. Google Scholar
[2]
Patsiogiannis N, Kanakaris NK, Giannoudis PV. Periprosthetic hip fractures: an update into their management and clinical outcomes. EFORT Open Rev. Jan 2021;6(1):75-92. doi:10.1302/2058-5241.6.200050. Google Scholar
[3]
Yang TC, Tzeng YH, Wang CS, Lin CC, Chang MC, Chiang CC. Are proximal screws necessary for osteosynthesis of stable-stem periprosthetic femoral fractures fixed with non-locking plate and cable? Injury. Oct 2019;50(10):1739-1744. doi:10.1016/j.injury.2019.06.009. Google Scholar
[4]
Sheridan GA, Galbraith A, Kearns SR, Curtin W, Murphy CG. Extended trochanteric osteotomy (ETO) fixation for femoral stem revision in periprosthetic fractures: Dall-Miles plate versus cables. Eur J Orthop Surg Traumatol. Apr 2018;28(3):471-476. doi:10.1007/s00590-017-2064-z. Google Scholar
[5]
Dargan D, Jenkinson MJ, Acton JD. A retrospective review of the Dall-Miles plate for periprosthetic femoral fractures: twenty-seven cases and a review of the literature. Injury. Dec 2014;45(12):1958-63. doi:10.1016/j.injury.2014.08.034. Google Scholar
[6]
Yoon BH, Lee YK, Jo WL, Ha YC, Choi DH, Koo KH. Incidence and Risk Period of Periprosthetic Femoral Fracture After Cementless Bipolar Hemiarthroplasty in Elderly Patients. J Arthroplasty. Jun 2016;31(6):1326-1330. doi:10.1016/j.arth.2015.12.030. Google Scholar
[7]
Stringer MR, Hooper GJ, Frampton C, Kieser DC, Deng Y. Periprosthetic fractures of the femur in primary total hip arthroplasty: a New Zealand Joint Registry analysis. ANZ J Surg. Mar 2021;91(3):404-408. doi:10.1111/ans.16611. Google Scholar
[8]
Park JW, Won SH, Kim HS, Won SJ, Lee YK, Koo KH. Current Incidence and Future Projection of Periprosthetic Fractures in South Korea: A Study Based on National Claim Database. Orthop Surg. Mar 2022;14(3):530-535. doi:10.1111/os.13219. Google Scholar
[9]
Giaretta S, Momoli A, Porcelli G, Micheloni GM. Diagnosis and management of periprosthetic femoral fractures after hip arthroplasty. Injury. Jul 2019;50 Suppl 2:S29-s33. doi:10.1016/j.injury.2019.01.053. Google Scholar
[10]
Haddad FS, Duncan CP, Berry DJ, Lewallen DG, Gross AE, Chandler HP. Periprosthetic femoral fractures around well-fixed implants: use of cortical onlay allografts with or without a plate. J Bone Joint Surg Am. Jun 2002;84(6):945-50. Google Scholar
[11]
Venu KM, Koka R, Garikipati R, Shenava Y, Madhu TS. Dall-Miles cable and plate fixation for the treatment of peri-prosthetic femoral fractures-analysis of results in 13 cases. Injury. Jun 2001;32(5):395-400. doi:10.1016/s0020-1383(01)00009-2. Google Scholar
[12]
Sandhu R, Avramidis K, Johnson-Nurse C. Dall-Miles cable and plate fixation system in the treatment of periprosthetic femoral fractures: a review of 20 cases. J Orthop Surg (Hong Kong). Dec 2005;13(3):259-66. doi:10.1177/230949900501300308. Google Scholar
[13]
Yenigül AE, Ermutlu C, Önder C, Atıcı T, Durak K. Outcomes of cable fixation after Vancouver type B1 periprosthetic femoral fractures. Ulus Travma Acil Cerrahi Derg. Oct 27 2023;29(11):1314-1319. Vancouver tip B1 Periprostetik femoral kırıklardan sonra kablo sabitlemenin sonuçları. doi:10.14744/tjtes.2023.87425. Google Scholar
[14]
Shah N, McCabe J. Dall-Miles cable and plate system for periprosthetic femoral fracture. Eur J Orthop Surg Traumatol. Jan 2002;12(3):137-9. Ostéosynthèse par câble de Dall-Miles et plaque pour fracture fémorale périprothétique. doi:10.1007/s00590-002-0040-7. Google Scholar
[15]
Marsland D, Mears SC. A review of periprosthetic femoral fractures associated with total hip arthroplasty. Geriatr Orthop Surg Rehabil. Sep 2012;3(3):107-20. doi:10.1177/2151458512462870. Google Scholar
[16]
Morgan S, Bourget-Murray J, Garceau S, Grammatopoulos G. Revision total hip arthroplasty for periprosthetic fracture: epidemiology, outcomes, and factors associated with success. Ann Jt. 2023;8:30. doi:10.21037/aoj-23-16. Google Scholar