Extract
To The Editor:I would like to make a few observations regarding the article "Mennen
Plate Fixation for the Treatment of Periprosthetic Femoral Fractures. A
Multicenter Study of Thirty-six Fractures" (2002;84:2211-5), by Noorda
and Wuisman.The study reviewed thirty-six periprosthetic fractures that had been
treated at twenty-one institutions in The Netherlands, which amounted to an
average of 1.7 operations per institution and, therefore, per surgeon. One has
to conclude that these surgeons had limited experience with the procedure and
thus were novices with respect to the technique. The article quite clearly
stated that, in the majority of cases, the postoperative management was not
followed as proposed by the instruction manual. The cases described in the
study ranged from the worst possible fractures to the simplest periprosthetic
fractures, which makes a comparative study illegitimate. At least from a
scientific point of view, the different fractures should have been analyzed
and placed into comparative groups. This categorization would allow one to
determine which factors are important and which are prognostic indicators of
outcome that can be used in the treatment of periprosthetic fractures.