Partridge osteosynthesis: A prospective clinical study on the use of nyloncerclage bands and plates in the treatment of periprosthetic femoral shaftfractures

Objective: To evaluate the clinical use of the Partridge osteosynthesis in periprosthetic femoral fractures. Design and Setting: Prospective nonrandomized clinical study. Patients: Over a ten-year period, 222 patients presenting with femoral frac tures near the tip of a hip prosthesis were treated with the Partridge syst em, which employs elevated cerclage nylon bands and flexible elevated nylon plates. Sixty-five fractures were located cranial to the: tip of the prost hesis (Whittaker Type 1), 116 at the tip (type II), and forty-one distal to the tip of the prosthesis (Type TIT). The population consisted of 172 fema le and fifty male patients, with a mean age of 79.5 years. The mean duratio n between the index procedure and occurrence of the second fracture was 1.5 years. In 78 percent of the patients (173 out of 222), surgery was underta ken within forty-eight hours. Fracture reduction was open, and two nylon pl ates set at right angles to each other were secured to the femur with six t o eight nylon bands. The mean operating time was fifty-five minutes, with a n average blood loss of 550 milliliters. Results: There were minor wound healing problems in eighteen patients (12.6 percent); there were no deep wound infections. Thirty-three elderly patien ts died within the first month from medical complications. Of the 189 remai ning patients, 60 percent regained their prefracture functional level withi n six months postoperatively, whereas 25 percent required a higher level of care. The mean time of the in-hospital stay was thirty-three days. Ninety- three percent of the fractures consolidated with abundant callus during the follow-up period of one year. Conclusion: The indication for the use of this simple osteosynthesis method is swift convalescence by splinting the periprosthetic femoral fractures. Even with a loose prosthesis, the fracture often healed with abundant callu s and the patient could be mobilized.