Treatment of Femoral Shaft Fractures after Total Hip Arthroplasty or Gamma Nailing -Use of Dall-Miles Cable and Compression Plate-

Abstract

Treatment of femoral shaft fractures following hip prostheses is difficult. We present five patients with periprosthetic femoral fractures. Four of these were after gamma nailing, one after total hip arthroplasty. They were all successfully treated by open reduction and fixation with Dall-Miles cables and compression plates. The Dall-Miles cable and plate system provides a reliable rigid internal fixation, without disturbing the bone cement or prosthesis. Fixation can also be augmented by unicortical or bicortical screws through the plate.
Excellent clinical outcome was seen in all five patients and we suggest that this augmented fixation method be given further consideration when planning the treatment of difficult periprosthetic fractures.