Fixation of periprosthetic femoral shaft fractures occurring at the tip ofthe stem - A biomechanical study of 5 techniques

This study evaluated 5 currently used periprosthetic femoral shaft fracture fixation techniques to determine which technique provided the greatest fix ation stability. Periprosthetic fractures in 30 synthetic femurs were fixed with a plate with cables, plate with proximal cables and distal bicortical screws (Ogden concept), plate with proximal unicortical screws and distal bicortical screws, plate with proximal unicortical screws and cables and di stal bicortical screws, or 2 allograft cortical strut grafts with cables. T hese specimens were then tested in 3 physiologic loading modes. The plate c onstructs with proximal unicortical screws and distal bicortical screws or with proximal unicortical screws, proximal cables, and distal bicortical sc rews were significantly more stable in axial compression, lateral bending, and torsional loading than the other fixation constructs studied.