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Ergebnisse und Komplikationen der Behandlung periprothetischer Femurfrakturen mit einem winkelstabilen Plattensystem

Results and complications in the treatment of periprosthetic femur fractures with a locked plate system

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Zusammenfassung

Hintergrund

Die Behandlung periprothetischer Femurfrakturen (PPF) ist mit einer erheblichen Komplikationsrate behaftet. Im Vergleich zu konventionellen Implantaten erlauben winkelstabile Plattensysteme eine stabile Fixation bei geringer Kompromittierung der Blutversorgung. Ziel war die Evaluation der Behandlungsergebnisse mit einem winkelstabilen Plattensystem (NCB-DF®).

Patienten und Methoden

Eingeschlossen wurden 31 Patienten (mittleres Alter 76 Jahre, 24 Frauen, 7 Männer) mit Femurfrakturen bei nicht gelockerter Hüft- (n=19) oder Knieprothese (n=12).

Ergebnisse

Es wurden 11 revisionsbedürftige Komplikationen beobachtet: 6 Implantatversagen (2 Patienten mit H-TEP, 4 Patienten mit K-TEP), 4 Hämatome, ein Infekt; 2 Patienten verstarben während des stationären Aufenthalts. Zum Zeitpunkt der Nachuntersuchung bestand eine feste Fusion bei allen Patienten, ein sekundärer Korrekturverlust wurde bei einem Patienten beobachtet.

Schlussfolgerung

Die NCB-DF®-Platte ist ein geeignetes Implantat für die Versorgung von PPF bei liegender Hüftprothese, problematisch erscheint jedoch die Rate an Implantatversagern bei liegender Knieprothese.

Abstract

Background

Locked plate devices offer advantages in the treatment of periprosthetic femur fractures associated with fixed total hip or total knee arthroplasty. The purpose of this study was to evaluate the early results and complications with a locked plate system (NCB-DF®).

Patients and methods

A total of 31 patients (mean age 76 years, 7 males, 24 females) with a femur fracture above a fixed total knee arthroplasty (TKA, n=12) or a total hip arthroplasty (THA, n=19) were treated with a locked plate.

Results

There were 11 complications necessitating revision: 6 implant failures, 2 in patients with a THA and 4 in patients with a TKA, 4 hematomas and 1 infection and 2 patients died. After 6 months all fractures had healed securely but a secondary correction was necessary in one patient.

Conclusion

Fixation of periprosthetic femur fractures with a locked plate system provided satisfactory results in patients with a THA, however, the relatively high implant failure rate in fractures above a stable TKA is a cause for concern.

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  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Zentrum für Chirurgie, Universitätsklinikum Ulm, Steinhövelstr. 9, 89075, Ulm, Deutschland

    J. Pressmar, F. Macholz, W. Merkert, F. Gebhard &  U.C. Liener

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  1. J. Pressmar
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  2. F. Macholz
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  3. W. Merkert
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Correspondence to U.C. Liener.

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Pressmar, J., Macholz, F., Merkert, W. et al. Ergebnisse und Komplikationen der Behandlung periprothetischer Femurfrakturen mit einem winkelstabilen Plattensystem. Unfallchirurg 113, 195–202 (2010). https://doi.org/10.1007/s00113-009-1665-3

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