Failure of the Noncontact Bridging Periprosthetic Plating System: A Single-Institution Experience
Bibliographic record
Abstract
Background: Periprosthetic femur fractures (PFFs) are challenging complications following total joint arthroplasty. Locking compression plates have emerged as a preferred option because of their stability and ability to be placed in a minimally invasive fashion. Surgical techniques for their application have been well-described; however, there are limited reports of failure. Here, we present 6 unique cases of implant failure using the Noncontact Bridging (NCB) Periprosthetic Plating System in the management of PFF. Methods: A retrospective chart review was conducted of all open reduction internal fixation procedures using the NCB plating system for PFF performed at a single tertiary academic trauma center from 2015 to 2022. Instances of postoperative implant failure were selected for review. Surgical information regarding their index PPF and subsequent open reduction internal fixations were collected. Results: Of the 44 instances the NCB plating system was used, 6 (13.6%) cases of implant failure were identified. Four out of 6 cases occurred within 4 months of fixation. Five of the failures were due to plate fracture and 1 by plastic deformation. Failure of the plate was noted at the tip of the prosthesis in 5 out of 6 cases. Stress concentration was minimized by avoiding the use of 3 consecutive screw plate holes in all cases. Conclusions: Here we present the largest case series to date of NCB plating system failure. These cases highlight the need for further surveillance of plate failure in the management of PFF, as well as ways in which system design could be improved. Level of Evidence: IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".