Large Locking Fusion Plate and Cable Fixation in the Treatment of Periprosthetic Femoral Fracture (PFF) After Total Hip Arthroplasty

Abstract

<i>Objective</i> To investigate the clinical effect of large locking fusion plate and cable fixation in the treatment of Periprosthetic femoral fracture (PFF) after total hip arthroplasty (THA). <i>Methods </i>Clinical data of 15 cases of PFF after THA treated with large locking fusion plate and cable fixation from June 2012 to June 2019 in our hospital were retrospectively analyzed. These cases included 4 males and 11 females, whose age were 61-82 years old, with an average age of 71.3 years, 6 cases on the left side and 9 cases on the right side. We performed total hip arthroplasty in 10 patients and hemiarthroplasty in 5 patients. There were 5 cases of Type B1 fracture, 8 cases of type B2 fracture, and 2 cases of type B3 fracture. Preoperative and postoperative hip function, HSS score, Harris score and surgical complications were observed and evaluated. <i>Results </i>15 patients were followed up 15-77 months after the operation (mean 36.9 months), and the hip function was significantly improved. The preoperative HSS score of knee function was 4.13±1.69, and the postoperative HSS score of knee function was 90.93±3.06, with11 excellent cases, 4 good cases and 0 general cases, with an excellent rate of 100%. Preoperative Harris score of knee function was 3.73±1.16. Harris score of hip function was 89.33±3.73 at the last follow-up. Among of all Harris scores, 10 cases were excellent, 3 cases were good, and 2 cases were general, with an excellent rate of 86.7%. Postoperative HHS and Harris scores were higher than those before surgery (P=0.031, P<0.001). No blood vessel or nerve injury occurred during the operation. During the postoperative follow-up, no complications such as periprosthetic infection, loosening, dislocation, nonunion of fracture and refracture occurred in 14 cases, and one case suffered refracture after the operation, which was healed after the nail and stick system fixation. <i>Conclusion</i> The application of large locking fusion plate and cable in the treatment of femoral periprosthetic fractures after total hip arthroplasty is simple, easy to operate, less complications, satisfactory clinical results, and worthy of promotion.