Abstract text (incl. references and figure legends)
Introduction: This study aimed to compare the clinical outcomes of well-fixed periprosthetic femoral fractures after hip arthroplasty according to augmentation with attachment plate.
Patients and methods: The medical records of patients who underwent reduction and internal fixation of Vancouver type B1 and C periprosthetic femoral fractures after hip arthroplasty were retrospectively obtained from a single center. Data on demographic data, injury mechanism, fracture pattern including open fractures and Vancouver classification, cause of hip arthroplasty, time interval between fracture and arthroplasty, and surgical method were recorded. Functional outcomes including Koval and HHS Score at postoperative 1 year were reviewed. The need for reoperation was also reviewed. Radiologic findings included union time and anatomical alignment of femur at the last radiologic follow-up. We compared surgical outcomes according to augmentation of attachment plate use.
Results: Twenty nine patients were included. Their mean age was 79.5 years, and the mean follow-up period was 18.4 months. There were 19 cases of Vancouver type B1 fractures and 10 cases of type C fractures. There were 13 patients of use of attachment plate (group 1); 16 patients of non-use (group 2). One patient in group 1 (7.7%) and 7 (43.8%) in group 2 had a nonunion or delayed union (p = 0.07). One (6.25%) patient in group 2 underwent revision surgery. Koval scores at postoperative 1 year were 3.7 ± 2.2 in group 1 and 3.2 ± 2.5 in group 2, respectively (p = 0.589). HHS scores at postoperative 1 year were 71.1 ± 13.8 in group 1 and 65.0 ± 26.7 in group 2, respectively (p = 0.505). Beals-Towers criteria revealed excellent or good outcomes (group 1, 100% vs. group 2, 87.5%, p = 0.051). Group 1 has less unsatisfactory outcomes (7.7% vs 43.8%, p = 0.044).
Conclusion: Internal fixation with augmentation with attachment plate in the well-fixed periprosthetic fractures following showed good clinical outcomes.
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