Does an additional attachment plate improve fixation in Vancouver type B1 and C periprosthetic femoral fractures? A retrospective comparative study.

Introduction: This study compared the clinical and radiologic outcomes of well-fixed periprosthetic femoral fractures after hip arthroplasty according to the use of single plate fixation with additional attachment plate device (group 1) or not (group 2).

Materials and methods: Retrospective data were obtained from a single center by reviewing medical records of patients who underwent reduction and internal fixation of Vancouver type B1 and C periprosthetic femoral fractures between June 2006 and June 2021. The study analyzed patient demographics, fracture characteristics, surgical details, functional outcomes (Harris hip score [HHS] and Koval score at 1-year follow-up), reoperation rates, and radiologic findings. In this study, nonunion and malunion were defined as indicators of "healing problems."

Results: Among the 32 included patients (group 1: 15; group 2: 17), fractures resulted from high-energy (six cases) and low-energy (26 cases) injuries, with no open fractures. The fractures included 21 cases of Vancouver type B1 and 11 cases of type C. One patient (6.7%) in group 1 required revision surgery. Excellent or good outcomes were observed in 100% of group 1 and 88.2% of group 2 patients according to Beals-Tower criteria (p = 0.031). Healing problems occurred in 6.7% and 41.2% of patients in groups 1 and 2, respectively (p = 0.03). HHS score, Koval score, union time, or femoral alignment did not differ significantly between the two groups (p > 0.05).

Conclusions: Using an additional plate in the treatment of well-fixed periprosthetic femoral fractures yielded better clinical outcomes compared to cases without an additional plate. Lower rates of nonunion or delayed union and improved overall healing were observed in the augmented group.