Ogden plate and other fixations for fractures complicating femoral endoprostheses.

Treatment of femoral shaft fractures complicating endoprostheses remains controversial. Nineteen such fractures were treated with open reduction and internal fixation using the Ogden plate. This modified plate allows for proximal fixation with heavy-duty Parham bands and distal fixation with screws. Sixteen of 19 patients healed their fractures in an average of 3.5 months. Two fractures developed delayed unions, one resulted in non-union. At final follow-up examination, results were rated as excellent (12), satisfactory (5), and poor (2). The procedure is not technically difficult. It can be applied to fractures both above and below the prosthetic tip as well as those with and without cement. Use of the Ogden plate provides immediate rigid fixation allowing early mobilization, preventing the complications of traction and/or cast immobilization.