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Use of Locking Plate and Strut Onlay Allografts for Periprosthetic Fracture Around Well-Fixed Femoral Components

Title
Use of Locking Plate and Strut Onlay Allografts for Periprosthetic Fracture Around Well-Fixed Femoral Components
Authors
Kim, Young-HooMansukhani, Sameer AjitKim, Jun-ShikPark, Jang-Won
Ewha Authors
김준식박장원
SCOPUS Author ID
김준식scopus; 박장원scopus
Issue Date
2017
Journal Title
JOURNAL OF ARTHROPLASTY
ISSN
0883-5403JCR Link1532-8406JCR Link
Citation
vol. 32, no. 1, pp. 166 - 170
Keywords
locking platestrut onlay allograftperiprosthetic fracturewell-fixed femoral componentclinical resultsradiographic results
Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Background: The purpose of this study was to determine: validated clinical and radiographic outcomes of periprosthetic femoral fractures around stable hip implants treated with plate fixation and additional cortical strut onlay allografts without revision of the stem; radiographic signs of fracture healing; allograft-to-host bone union; resorption of cortical strut allograft; and frequency of complications. Methods: At our institute, 24 patients (25 hips) were identified with Vancouver type B1 fracture at the tip of the femoral stem and one patient (one hip) was identified with a Vancouver type C fracture of the femur. All these fractures were treated with combined use of locking plate fixation and cortical strut onlay allografts. There were 18 women and 7 men, with an average age of 63 years. Harris hip score and University of California, Los Angeles activity score were used to assess postoperative function. The average duration of follow-up was 3.7 years (range, 1-7 years). Results: Harris hip score at final review was 86 points (range, 65-95 points). University of California, Los Angele activity score averaged 5.8 +/- 1.3 point (range, 3.5-10 points) at final follow-up. All but 2 patients returned to their preoperative functional level within 1 year. Twenty-three of 26 hips had fracture union following the first operation. Three hips were failed to obtain fixation because of insufficient length of plate and allograft. Cortical strut onlay allografts were incorporated in the host femur in all hips by one year. Minor resorption of allograft was noticed, but there was no failure of any of the cortical strut allografts. Conclusion: The cortical strut onlay allografts facilitated the mechanical stability and the biological fracture healing in addition to plate fixation. (C) 2016 Elsevier Inc. All rights reserved.
DOI
10.1016/j.arth.2016.05.064
Appears in Collections:
의과대학 > 의학과 > Journal papers
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