Periprosthetic femoral fractures around well fixed implants: A simple method of fixation using LC-DCP with trochanteric purchase

Published online: Apr 27 2007

Ramesh Sen, Prabhudev Prasad, Senthil Kumar, Onkarnath Nagi

Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India


Periprosthetic fractures of the femur are among the most serious complications in hip surgery. Various classifications have been suggested. At present the Vancouver classification system probably comes closest to the ideal. Most authors recommend internal fixation of the fractures in well-fixed implants (Vancouver type B1). However as the fixation to the proximal fragment has always been a problem, many types of fixation devices have been used. This retrospective study was done to evaluate the efficacy of an LC-DCP with trochanteric purchase, in the fixation of Vancouver type B1 periprosthetic femoral fractures. Our study included 12 patients, 7 male and 5 female with a mean age of 73 years (range : 57 to 91). One patient died due to complications not related to surgery and in another patient the plate was found broken with a loose implant, which was revised. All cases were primary arthroplasties. A long broad LC-DCP was used for the fixation. Purchase in the proximal fragment was obtained with screws in the greater trochanter. Ten fractures united in an average period of 7 months. The mean duration of follow-up was 6.5 years. The final results were evaluated using the Harris hip score. The mean Harris hip score was 85 with a range of 75 to 94.