The choice of locking plate in the treatment of peri-implant femoral fracture eight years after trans-trochanteric rotational osteotomy: A case report. (2016)

• Record Type: Journal Article
• Authors: Utsunomiya, Takeshi; Yamamoto, Takuaki; Motomura, Goro; Karasuyama, Kazuyuki; Sonoda, Kazuhiko; Kubo, Yusuke; Hatanaka, Hiroyuki; Iwamoto, Yukihide
• Is Part Of: International journal of surgery case reports. Volume 26(2016)
• Page Start: 101
• Page End: 103
• Publication Date: 2016
• Subjects: Trans-trochanteric rotational osteotomy -- Peri-implant fracture -- Osteosynthesis -- Osteonecrosis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.07.020
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: We report a peri -implant fracture after transtrochanteric rotational osteotomy. Preservation of the nutrient artery of the femoral head is important. The entry point of an anterograde nail would have been very close to the artery. A locking plate is preferable to ante-grade nailing to avoid damaging the artery. The operation resulted in satisfactory results without any complications. Abstract: Introduction: Transtrochanteric anterior rotational osteotomy of the femoral head (TRO) was developed as a joint preserving surgery for osteonecrosis of the femoral head. To the best of our knowledge, peri -implant fractures after femoral osteotomy have rarely been reported. Presentation of case: We report a 58-year-old female who suffered a peri -implant femoral shaft fracture following a fall from a stepladder eight years after TRO. Fracture union was achieved six months after a preferred proximal femoral locking plate. Discussion: The entry point of the ante-grade femoral nail would have been very close to the new position of the nutrient artery of the femoral head occasioned by the TRO and to avoid injury, we chose proximal femoral locking plate. Conclusion: It is important to consider the new position of the nutrient artery of the femoral head in the surgical planning of peri -implant fracture after TRO.