A comparison between nail-plate constructs and the plate-on-plate technique in the treatment of proximal femoral peri-implant fracture

Study design: A single-centre, retrospective cohort study. Objectives: To compare the clinical outcomes between nail-plate constructs and the plate-on-plate technique in the treatment of proximal femoral peri-implant fracture (PFPIF). Methods: Thirty-seven patients with PFPIF treated at our hospital were included. All patients underwent at least 1-year follow-up. Imaging studies and medical records, including walking ability, complications, and functional outcomes 1 year after surgery, were thoroughly reviewed. Results: Twenty patients were treated with nail-plate constructs. Seventeen patients were treated with the plate-on-plate technique. The average surgical times in the plate-on-plate technique and nail-plate construct groups were 119.4 ± 23.4 min and 246.3 ± 48.0 min, respectively. The average blood losses in the plate-on-plate technique and nail-plate construct groups were 124.7 ± 41.6 mL and 434.3 ± 170.8 mL, respectively. The plate-on-plate technique group had a significantly shorter surgical time and less blood loss than the nail-plate construct group. No statistically significant differences were found in union time, ambulation status, 36-item Short Form Health Survey score, and complication rate between the two groups. Conclusion: The plate-on-plate technique can be considered an alternative option to reduce operation time and blood loss in the treatment of PFPIF, especially for older patients and those who are less capable of sustaining long-term operation and anaesthetic exposure.