Comparison of therapeutic outcomes of periprosthetic femoral fracture between treatments employing locking and conventional plates

Abstract

Locking plate is considered biomechanically advantageous for porotic bone, compared with conventional plate. However, clinical evaluations of locking and conventional plates for periprosthetic femoral fracture are still controversial. Thus, we investigated the usefulness of a locking plate compared with the conventional plate for treatment for this fracture. We reviewed 40 patients (40 fractures) who had undergone internal fixation for Vancouver type B1 or C periprosthetic fracture. Locking and conventional plates were applied for 21 and 19 patients, respectively. No significant difference was found between locking and conventional plate groups in Merle d' Aubigné hip score, walking ability, operation time, and blood loss. Regarding postoperative complications, delayed union was noted in one patient in the locking plate group and subsidence of the stem in one in the conventional plate group. On the final follow-up, bone union was achieved in all patients. We cannot suggest the usefulness of locking plate for periprosthetic femoral fracture. However, functional training was performed in the same rehabilitation schedule in our comparative study. Considering the angle stability of the locking plate, weight may be loaded on the locking plate, earlier than that on the conventional plate, which may be an advantage of the locking plate.