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Eur J Orthop Surg Traumatol ; 30(3): 539-543, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31641841

ABSTRACT

Inter-implant fractures are associated with reduced quality of life and increased 1-year mortality. For that reason, we propose, instead of treating, a novel, preventative surgical approach that involves splinting the inter-implant femoral shaft interval. In patients with a previous femoral implant in whom a second surgery for new material implantation was necessary (including knee or hip arthroplasty, plate or femoral nailing), an overlapping technique using the minimally invasive plate osteosynthesis technique was performed during the second surgery. Nine patients were included, all females with median (range) age of 78 (55-88) years. No surgery-related complications or mortality occurred. Two patients suffered fractures from a casual fall postoperatively with no implant failure or hospital admission required. In conclusion, instead of treating such fractures after they occur, we propose an effective, safe and reproducible preventative surgical approach, not previously reported, which involves internal femoral splinting, a plate and the minimally invasive plate osteosynthesis technique.


Subject(s)
Periprosthetic Fractures/prevention & control , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/methods , Bone Plates , Female , Femoral Fractures/diagnostic imaging , Femoral Fractures/prevention & control , Femur/diagnostic imaging , Femur/surgery , Health Services Needs and Demand , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/instrumentation , Minimally Invasive Surgical Procedures/methods , Periprosthetic Fractures/diagnostic imaging , Prospective Studies , Radiography , Reoperation
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