Is the 95°blade plate still important in the treatment of proximal femoral pseudarthrosis?

Abstract

Due to demographic changes, fractures and subsequently delayed fracture healing as well as pseudarthrosis of the proximal femur are on the increase. In the acute fracture situation, aload-stable treatment with an intramedullary implant (cephalomedullary nail) is generally sought. To date, there is no uniform consensus on the optimal treatment for complicated cases. The aim of this study was to evaluate the clinical and radiological outcome after revision of pseudarthrosis using a95° blade plate in aseptic proximal femoral pseudarthrosis and to identify the specifications of blade plate treatment.The retrospective study design was used to evaluate data, some of which were prospectively collected. The study period covered January 2010 to December 2020 and 22patients (10women, 12men) with an average age of 59years were included in this single-center study. All patients showed pseudarthrosis after afemoral fracture type AO31 A1-A3 or proximal femoral fracture type AO 32 A-C. Clinical and radiological follow-up were performed after 3, 6and 12months. Functional outcomes were assessed using the modified Harris hip score (mHHS), the numerical rating scale (NRS) and the short form health survey (SF-12).The postoperative radiological results after reosteosynthesis using ablade plate showed good results and 86.4% of the patient population were healed during the observation period. Pseudarthrosis persisted in four patients and was surgically revised.The functional results showed good results on average, albeit with ahigh dispersion of 17-91points in the mHHS. The SF-12 averaged 42.6 (±10.4) points and the psychological score49.4 (±9.6) points. The postoperative pain level was low both at rest and under stress.It was shown that reosteosynthesis with ablade plate is asurgically demanding but effective treatment option with alow potential for infection and safe bone consolidation, especially for the correction of high-grade axial deviation or varus malalignment.