Surgical Techniques of Using Direct Anterior Approach and Bridging Plate Fixation of Periprosthetic Fracture of an Arthrodesed Hip: A Case Report

Abstract

We present a case of a 65-year-old woman with traumatic periprosthetic fracture of left proximal femur with ipsilateral arthrodesed hip and cobra plate in-situ. It imposes challenges on achievement of stable fixation for fracture management and preservation of blood supply for fracture healing. Minimally invasive plate osteosynthesis through direct anterior approach was executed with intraoperative templating. Anterior bridging plating using pre-bent reverse distal femoral locking compression plate (less invasive stabilisation system) was performed successfully. The patient had a fracture union in 10 months and returned to the previous mobility status. This technique can achieve stable fixation and preservation of blood supply for fracture healing through minimal invasive technique. 中文摘要: 本文報告一名六十五歲女士，患有左側近端股骨創傷性人工假體周圍骨折，同時同側有髖關節融合，並伴有眼鏡蛇鋼板。要達到穩定固定及保持血供以促進骨折癒合,實是一大挑戰。通過直接前路及術中模板，進行了微創鋼板骨折接合術。我們成功使用預設彎曲反向遠端股骨鎖定鋼板進行前面橋狀鋼板固定。患者骨折在術後十個月內癒合，她恢復了從前的活動狀態。這種技術可以通過最少侵入性技術，保存血供並把骨折穩定固定以達至骨折癒合。 Keywords: fracture, hip arthrodesis, minimally invasive plate, periprosthetic