The Mennen femoral plate for fixation of periprosthetic femoral fractures following hip arthroplasty☆
Introduction
Periprosthetic fractures following hip arthroplasty are difficult to treat and there are various modalities available for the fixation of these fractures. One such device is the Mennen plate, which is a paraskeletal clamp-on plate first described in 1984 for the fixation of forearm fractures [1], [2].
The advantages of this device were thought to be as follows: (1) soft tissue dissection is minimal hence the already compromised blood supply after the fracture is not damaged further. (2) After the plate is crimped onto the bone it creates an oval configuration which helps maintain the vascularity of the bone. (3) The plate is not fixed onto the bone with screws and hence does not cause any added endosteal damage. Thus the semi rigid device was expected to favour biological union [1], [2].
Periprosthetic femoral fractures occur either intra or post operatively. The incidence of these fractures following primary hip arthroplasty is about 0.1–1.1% and about 1.5–2.8% following revision arthroplasty [3].
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Materials and methods
Periprosthetic femoral shaft fractures following hip arthroplasty were stabilised using the Mennen plate in 16 patients between 1992 and 1995. None of these patients had any evidence of radiological loosening of the prosthesis. All patients sustained the fractures following a trivial fall. Fractures were classified by Johansson's system [4]. Operative stabilisation was carried when the patients were optimally fit for surgery.
A lateral approach was used to expose the fracture and the Mennen
Results
Sixteen patients from three different centres from South Wales were included in the study. There were six males and 10 females in the study group. The average age of the patients was 75.5 years (range 57–89 years). The average time from the hip arthroplasty to fracture was 7 years (range 3 months–17 years). Twelve patients had a Charnley total hip replacement, two had an Austin Moore hemiarthroplasty, and one each had a Howse II and Norwich hip replacement.
There was one type I fracture, ten
Discussion
Periprosthetic fractures around a hip arthroplasty are not uncommon. Treatment options include conservative measures, internal fixation or revision arthroplasty. Internal fixation of these fractures has been achieved with various types of plates. The Mennen femoral plate is one of these devices.
Lam et al. [5] in 1982 first presented this technique of the use of Mennen plates in six patients. Two of the six patients in the study had complications, i.e. fracture disruption. It was felt that the
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Cited by (0)
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Work attributed to: Morriston Hospital, Swansea, Neath General Hospital and West Wales General Hospital, Carmarthen.