Authors
Nazarov D.S.1, Ajrapetov G.A.1, Zagorodnij N.V.1, 2, Mironov A.N.3, Karpovich N.I.1, Lukin M.P.3, Burkov D.V.3, Dzhodzhua A.V.4
1 Peoples’ Friendship University of Russia named after Patrice Lumumba, Moscow
2 Research Center for Traumatology and Orthopedics named after N.N. Priorov, Moscow
3 City Clinical Hospital No. 31 named after Academician G.M. Savelyeva, Moscow
4 Pirogov National Medical and Surgical Center, Moscow
Abstract
Background. Global population aging has led to a significant increase in femoral neck fractures (FNF) among elderly patients. Despite the widespread use of cannulated screws, complication rates reach 46%, prompting the search for alternative techniques such as Biplanar Double-Supported Fixation (BDSF).
Objective. To present a rare complication of BDSF – periprosthetic subtrochanteric fracture – and analyze its etiological factors.
Materials and Methods. We describe a clinical case of a 64-year-old female with Garden type II FNF complicated by a periprosthetic fracture 1.5 months after BDSF. Data from a cohort of 31 patients who underwent BDSF between September 2021 and December 2024 at City Clinical Hospital No. 31 were analyzed.
Results. Periprosthetic subtrochanteric fracture occurred in 3.2% of cases (n=1). Revision osteosynthesis with an intramedullary nail resulted in a successful outcome.
Conclusion. This case highlights the necessity of strict adherence to the biomechanical principles of BDSF (Biplane Double-Supported Fixation) and the development of a guiding device for distal screw insertion, which would minimize the risk of repeat peri-implant femoral fractures.
Keywords: Femoral neck fracture, Biplane Double-Supported Fixation (BDSF), Periprosthetic fracture, Osteosynthesis, Complications.
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