Treatment of periprosthetic femoral fractures with unstable prosthesis by replacement of long-stem femoral prosthesis
10.3760/cma.j.issn.1671-7600.2016.02.016
- VernacularTitle:更换长柄股骨假体结合内固定治疗假体松动型股骨假体周围骨折
- Author:
Jinliang WANG
;
Xiaofei LUO
;
Xuan WEI
;
Shaohua WANG
;
Yingzhou HOU
;
Songtao CAI
;
Jingtao SUN
- Publication Type:Journal Article
- Keywords:
Arthroplasty,replacement,hip;
Femoral fractures;
Postoperative complications;
Prostheses and implants
- From:
Chinese Journal of Orthopaedic Trauma
2016;18(2):169-171
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the treatment of periprosthetic femoral fractures (PFF) with unstable prosthesis by replacement of long-stem femoral prosthesis and internal fixation.Methods From December 2005 to December 2014,15 PFF patients with unstable prosthesis (15 hips) following were treated at our department.They were 10 men and 5 women,aged from 64 to 89 years (mean,76.2 years).Their primary surgeries included total hip arthroplasty in 13 cases and biological bi-polar replacement of femoral head in 2.Two prostheses were cement and 13 biological.By Vancouver classification,9 cases were type B2,and 6 type B3.The unstable prostheses in the 15 cases were replaced by long-stem femoral ones,followed by internal fixation.At the last follow-ups,clinical outcome were evaluated by Harris scoring and images of PFF by Beals & Tower criteria.Complications were documented.Results One died 4 months after operation.The other 14 patients were followed up for an average of 4.5 years (from 6 months to 9 years).Fracture union was achieved in 12 cases after an average of 3.9 months (from 3 to 9 months).Nonunion occurred in 2 cases.Imaging evaluation revealed 9 excellent cases,3 good ones and 2 poor ones.The Harris scores at the last follow-up averaged was 82.3 points (from 50 to 100 points).Deep vein thrombosis occurred preoperatively in one case and posterior tibial vein thrombosis occurred in 2 cases respectively on day 3 and day 10 postoperatively.No such complications occurred as malunion,fixation failure,dislocation or prosthesis loosening.Conclusion Satisfactory outcomes can be achieved by replacement of long-stem femoral prosthesis combined with appropriate fixation for treatment of PFF with unstabrosthesis.
