Locking plate fixation for Vancouver B1 periprosthetic femoral fractures: a critical analysis of 135 cases

LCP has been used successfully in the management of Vancouver B1 PPF. However, potential areas of improvement include, leaving the fracture site free of locking screws, therefore, not disturbing the soft tissue envelope around the fracture and also reducing plate stiffness. Adding cortical strut allografts to improve stability and bone quality, if needed, may also improve outcome. Limitations in the use of strut grafts or transverse fractures below the tip of the stem that cannot be controlled with single or double plating may require long stem revision to achieve axial stability.