Challenges of plate fixation for Vancouver type-C fractures after a well-fixed hip arthroplasty femoral stem

Document Type: LETTER TO THE EDITOR

Author

Department of Orthopedic Surgery, Assistant Professor, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran

Abstract

The fixation of distal femoral fractures (Vancouver type-C fractures) following a well-fixed hip arthroplasty femoral stem has become a challenging issue for orthopedic surgeons due to the inter-prosthetic biomechanical effects such as negative, positive, and torsional strain. Surgeons have applied a range of constructs to overcome these difficulties. To minimize the risk of inter-prosthetic fracture between well-fixed femoral stem and lateral femoral plate, many surgeons prefer to fix these fractures by overlapping the lateral femoral plate over the tip of the well-fixed femoral stem or overlapping with the proximal femoral component along with soft tissues sparing techniques using long plates, while others prefer to separate (non-overlap) the palate from the femoral stem.

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