The Mennen plate: unsuitable for elderly femoral peri-prosthetic fractures

The Mennen plate has been advocated for femoral shaft and femoral peri-pros thetic fractures. We utilised this fixation system in five patients with pe ri-prosthetic femoral shaft fractures. The operative technique was that des cribed by the CMW laboratories. The postoperative regimen deviated from tha t recommended, i.e. prolonged bed-rest, since the patients were elderly and complicated by chest problems and pressure sores. Once the surgical wounds had healed, at an average of 11 days (range 10-14 days), one patient achieved non-weight-bearing mobilisation. Four patients were managed with bed-to-chair transfer only. Pill five plates failed at an average of 32 days (range 15-42 days). Only one patient had an identifiabl e accident to account for the failure. Two patients underwent revision hip arthroplasty and two had revision fixation with Dall-Miles (Howmedica), and Cable Ready (Zimmer) plate and cables. Femoral shaft peri-prosthetic fractures are not adequately stabilised with the Mennen plate system, and prolonged recumbency in such an elderly popula tion often worsens pre-existing medical problems. We advocate the use of on e of the many available plate and cable fixation systems for such fractures in the elderly and in those in whom revision arthroplasty may not be possi ble. (C) 1999 Elsevier Science Ltd. All rights reserved.