Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes

Christopher E Henderson; Michael Bottlang; J Lawrence Marsh; Dan C Fitzpatrick; Steven M Madey

$Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes$

Journal article

Open access

Peer reviewed

Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes

Christopher E Henderson, Michael Bottlang, J Lawrence Marsh, Dan C Fitzpatrick and Steven M Madey

The Iowa orthopaedic journal, Vol.28, pp.73-76

2008

PMCID: PMC2603353

PMID: 19223952

Appears in Diamond Open Access

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url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603353/View

Published (Version of record) Open Access

Abstract

Contemporary locking plates promote biological fixation through indirect reduction techniques and by elevating the plate from the bone. They have improved fixation strength in osteoporotic bone. Periarticular locking plates are rapidly being adopted for bridge plating of periprosthetic femur fractures. When these plates are used for indirect reduction and bridge plating osteosynthesis, fracture union occurs by secondary bone healing with callus formation which is stimulated by interfragmentary motion. In two patients with similar periprosthetic femur fractures treated with periarticular locking plates one fracture healed by ample callus formation while the other resulted in a non-union and had no callus formation six months post-operatively. The case, which progressed to secondary bone healing with callus formation, exhibited varus migration as a result of loss of fixation. The non-union case retained stable fixation. The difference in outcome may indicate that callus formation was promoted by interfragmentary motion secondary to loss of fixation. Conversely, in absence of fixation failure, callus formation was suppressed by stable fixation with a stiff locking plate construct which reduced interfragmentary motion. These observations suggest that locked plating constructs should be sufficiently flexible when applied for bridge plating of comminuted fractures to promote callus formation.

Radiography

Humans

Hip Prosthesis

Bone Plates

Femoral Fractures - diagnostic imaging

Biomechanical Phenomena

Fracture Healing

Fracture Fixation, Internal - instrumentation

Treatment Failure

Femoral Fractures - surgery

Female

Aged

Accidental Falls

Details

Title: Subtitle: Does locked plating of periprosthetic supracondylar femur fractures promote bone healing by callus formation? Two cases with opposite outcomes
Creators: Christopher E Henderson - University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
Michael Bottlang
J Lawrence Marsh
Dan C Fitzpatrick
Steven M Madey
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.28, pp.73-76
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 19223952
PMCID: PMC2603353
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2008
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040541102771

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