Version 1
: Received: 6 November 2024 / Approved: 6 November 2024 / Online: 6 November 2024 (12:53:42 CET)
How to cite:
Wellauer, H.; Gautier, E.; Klaeser, B.; Meyer, N.; Meier, C.; Wahl, P. Symptomatic Osteonecrosis of the Femoral Diaphysis Induced by Internal Plate Fixation of a Periprosthetic Fracture. Preprints2024, 2024110415. https://doi.org/10.20944/preprints202411.0415.v1
Wellauer, H.; Gautier, E.; Klaeser, B.; Meyer, N.; Meier, C.; Wahl, P. Symptomatic Osteonecrosis of the Femoral Diaphysis Induced by Internal Plate Fixation of a Periprosthetic Fracture. Preprints 2024, 2024110415. https://doi.org/10.20944/preprints202411.0415.v1
Wellauer, H.; Gautier, E.; Klaeser, B.; Meyer, N.; Meier, C.; Wahl, P. Symptomatic Osteonecrosis of the Femoral Diaphysis Induced by Internal Plate Fixation of a Periprosthetic Fracture. Preprints2024, 2024110415. https://doi.org/10.20944/preprints202411.0415.v1
APA Style
Wellauer, H., Gautier, E., Klaeser, B., Meyer, N., Meier, C., & Wahl, P. (2024). Symptomatic Osteonecrosis of the Femoral Diaphysis Induced by Internal Plate Fixation of a Periprosthetic Fracture. Preprints. https://doi.org/10.20944/preprints202411.0415.v1
Chicago/Turabian Style
Wellauer, H., Christoph Meier and Peter Wahl. 2024 "Symptomatic Osteonecrosis of the Femoral Diaphysis Induced by Internal Plate Fixation of a Periprosthetic Fracture" Preprints. https://doi.org/10.20944/preprints202411.0415.v1
Abstract
Periprosthetic fractures of the proximal femur are one of the most frequent causes of revision after total hip arthroplasty. Internal fixation may be chosen if the hip implant is stable or if a stable fixation may be obtained. Preservation of bone perfusion and adequate stability are essential for successful fracture healing. As presented in this report, a patient developed both osteonecrosis and atrophy of the cortical bone due to use of a specific plate to treat a periprosthetic fracture of the femur. An 82-year-old female sustained a periprosthetic fracture of the proximal femur two years after cemented hemiarthroplasty. The fracture was treated by plate fixation. Along the proximal femoral diaphysis, cerclages were applied to avoid interference of screws with the femoral stem. Due to postoperative restrictions and finally due to pain, the patient never could be mobilized out of a wheelchair. After 4 years, pain persisted while the fracture had healed without loosening of the joint replacement components. However, pronounced atrophy of the whole femur was present, with devitalized areas of the bone underlying the plate. When not strictly applied as an internal fixator at a distance from the bone, the plate model used in this case may disturb periosteal blood flow, causing osteonecrosis. Furthermore, high bending rigidity of the plate-bone construct may lead to stress shielding and atrophy. The case illustrates that design and mechanical properties of a plate are relevant in bone biology and healing.conclusions. Clinical trial abstracts should include items that the CONSORT group has identified as essential.
Keywords
Periprosthetic fracture; femur; Plate fixation; internal fixation; bone biology; bone necrosis; plate contact
Subject
Medicine and Pharmacology, Orthopedics and Sports Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
