Treatment of periprosthetic femoral fractures after total hip arthroplasty
- VernacularTitle:全髋关节置换术后股骨假体周围骨折的治疗
- Author:
Yixiong ZHOU
;
Ming LU
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, hip;
Postoperative complications;
Femoral fractures;
Treat-ment outcome
- From:
Chinese Journal of Orthopaedics
1999;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the causes and results of treatment of periprosthetic femoral frac-tures after total hip arthroplasty and to explore the best operative methods for fractures. Methods 11 cases treated for periprosthetic femoral fracture after total hip arthroplasty were subjected to a retrospective fol-low-up study from December 1998 to March 2003. There were 8 men and 3 women, the mean age was 56 years (range, 43 to 75 years). There were 2 Vancouver A type fractures, 7 B2 type, 1 B3 type, 1 C type. 5 fractures were treated by nonoperative methods and other 6 by operative methods, including one fracture malunion treated initially by skin traction. There were 5 revisions using long stem supplemented with cortical allograft strut, including 4 uncemented stems with distal fixation and one cemented stem; the remaining one fracture treated by open reduction and internal fixation. Results None was lost for follow-up. The mean follow-up period was 25.6 months (range, 7 to 50 months). 9 fractures united at a mean of 4 months (range, 3 to 6 months). Nonunion was found in 2 fractures, both were treated nonoperatively. All the 6 fractures treated by operative methods united. Up to now, 7 stems were well-fixed, continuous radiolucent line was seen in one revision case, 3 stems were loosened. The function of the patients with well-fixed stems was bet-ter than those with loosened stems, the mean Harris score of the former was 91. All the cortical allograft struts were incorporated with host bone within one year. No strut fracture happened. Conclusion Type A fractures with well-fixed stems can be treated by nonoperative methods, while type B1 and type C fractures should be treated by open reduction and internal fixation, on condition there is no surgical contraindication. For fractures with loosened stems, use of an uncemented long stem with distal fixation supplemented with cortical allograft strut is the best choice.
