Periprosthetic Femoral Fractures: 10 Years Clinical Experience Using a Fracture Specific Fixation System: A Retrospective Study

Background/Objectives: The incidence of periprosthetic femoral fractures is increasing with rising use of hip and knee arthroplasty. Management of these fractures is complex and requires specialist skills and equipment. We aimed to assess out-comes/complications in over 100 patients treated with the Zimmer Biomet Non-contact Bridging (NCB) plate for femoral periprosthetic fractures. Methods: Patients admitted with periprosthetic femoral fractures from 2012 to 2022 were identified via the hospital’s electronic system. Admission details, follow up and radiographs were reviewed. Results: 111 patients were treated with NCB plates for periprosthetic femoral fractures. The mean age of patients was 78, with a median hospital stay of 20 days. 72 (64.8%) were ASA 3 or above. 69 (62%) fractures involved hip replacements, 42 (37%) involved knee replacements. Inter-prosthetic fractures accounted for 12.6% (n=14) of cases. The com-monest fracture pattern was UCS B1(44.1%). Plate length varied between 18 Hole plates (n=8) and 9-hole plates (n=47). Most patients were not allowed to weight-bear at all immediately post-op. 75 (68%) patients maintained or improved upon their pre-hospital mobility at final follow-up. 14 (13%) patients required more support when discharged home compared to preadmission. Non-union rate was 9.9%(n=11) with plate fractures occurring in 7 patients. The average working length in patients with non-union was 170mm. There were 2 in-patient deaths and mortality rate at 30 days and 1 year were 4.5% and 14.4% respectively Conclusions: The NCB plate is a popular, safe and reliable implant for treating these complex fractures.