Mercier Michael R, Broderick James M, Hibberd Catherine S, Russell Shane P, Halai Mansur M, Atrey Amit, Nauth Aaron, Khoshbin Amir
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, ON, Canada.
Arthroplast Today. 2025 Jun 26;34:101753. doi: 10.1016/j.artd.2025.101753. eCollection 2025 Aug.
Periprosthetic femur fractures (PFFs) are challenging complications following total joint arthroplasty. Locking compression plates have emerged as a preferred option because of their stability and ability to be placed in a minimally invasive fashion. Surgical techniques for their application have been well-described; however, there are limited reports of failure. Here, we present 6 unique cases of implant failure using the Noncontact Bridging (NCB) Periprosthetic Plating System in the management of PFF.
A retrospective chart review was conducted of all open reduction internal fixation procedures using the NCB plating system for PFF performed at a single tertiary academic trauma center from 2015 to 2022. Instances of postoperative implant failure were selected for review. Surgical information regarding their index PPF and subsequent open reduction internal fixations were collected.
Of the 44 instances the NCB plating system was used, 6 (13.6%) cases of implant failure were identified. Four out of 6 cases occurred within 4 months of fixation. Five of the failures were due to plate fracture and 1 by plastic deformation. Failure of the plate was noted at the tip of the prosthesis in 5 out of 6 cases. Stress concentration was minimized by avoiding the use of 3 consecutive screw plate holes in all cases.
Here we present the largest case series to date of NCB plating system failure. These cases highlight the need for further surveillance of plate failure in the management of PFF, as well as ways in which system design could be improved.
IV.
人工关节周围股骨骨折（PFF）是全关节置换术后具有挑战性的并发症。锁定加压钢板因其稳定性以及能够以微创方式置入而成为首选。其应用的手术技术已有详尽描述；然而，关于失败的报道有限。在此，我们呈现6例使用非接触桥接（NCB）人工关节周围钢板系统治疗PFF时出现植入物失败的独特病例。
对2015年至2022年在一家三级学术创伤中心进行的所有使用NCB钢板系统治疗PFF的切开复位内固定手术进行回顾性图表审查。选择术后植入物失败的病例进行审查。收集有关其初次PFF及后续切开复位内固定的手术信息。
在使用NCB钢板系统的44例病例中，确定有6例（13.6%）出现植入物失败。6例中有4例在固定后4个月内发生。6例失败中有5例是由于钢板断裂，1例是由于塑性变形。6例中有5例钢板失败发生在假体尖端。在所有病例中，通过避免连续使用3个螺钉钢板孔将应力集中降至最低。
在此我们呈现了迄今为止最大的NCB钢板系统失败病例系列。这些病例凸显了在PFF治疗中对钢板失败进行进一步监测的必要性，以及系统设计可改进的方面。
四级。
