Clinical and Epidemiological Characteristics of Periprosthetic Femoral Fractures Treated with an Anatomically Contoured Locking Plate: A Five-Year Single-Center Experience from the National Scientific Center of Traumatology and Orthopedics, Astana, Kazakhstan.

Periprosthetic femoral fractures (PFFs) are an increasingly common complication following total hip arthroplasty, especially in aging populations. This retrospective study analyzes a five-year experience at the National Scientific Center of Traumatology and Orthopedics in Astana, Kazakhstan, using a domestically developed anatomically contoured locking plate for surgical fixation. Thirty-eight patients were included, with the majority being elderly females. The most common fracture locations were the femoral shaft and distal femur. All patients underwent open reduction and internal fixation with the national plate system. No in-hospital complications, reoperations, or mortality were recorded. Clinical improvement at discharge was observed in all cases. ICU admission decreased over time, and the average hospital stay was significantly longer in patients aged ≥70 years. The plate's design enabled bicortical fixation around existing femoral stems, and the system demonstrated excellent short-term outcomes. This study supports the use of localized implant strategies in low- and middle-income countries and highlights the role of centralized surgical expertise. Further multicenter studies with long-term follow-up are recommended. Periprosthetic femoral fractures (PFFs) represent a serious complication following total hip arthroplasty (THA), particularly in elderly and osteoporotic patients. Their incidence is increasing in parallel with the global growth of primary arthroplasty procedures. In resource-limited settings, access to modular revision systems is often constrained, necessitating cost-effective and anatomically appropriate alternatives. This study aimed to evaluate the clinical characteristics, management strategies, and early outcomes of patients with PFFs treated using a domestically produced anatomically contoured locking plate at a national trauma center in Kazakhstan.