Challenges of Plate Fixation for Vancouver Type-C fractures after a Well-fixed Hip Arthroplasty Femoral Stem.

Abstract

The fixation of distal femoral fractures (Vancouver type-C fractures) following a well-fixed hip arthroplasty femoral stem has become a challenging issue for orthopedic surgeons due to the inter-prosthetic biomechanical effects such as negative, positive, and torsional strain. Surgeons have applied a range of constructs to overcome these difficulties. To minimize the risk of inter-prosthetic fracture between well-fixed femoral stem and lateral femoral plate, many surgeons prefer to fix these fractures by overlapping the lateral femoral plate over the tip of the well-fixed femoral stem or overlapping with the proximal femoral component along with soft tissues sparing techniques using long plates, while others prefer to separate (non-overlap) the palate from the femoral stem.