The treatment of periprosthetic femoral fractures after total hip arthroplasty
10.3760/cma.j.issn.0253-2352.2019.15.007
- VernacularTitle: 全髋关节置换术后股骨假体周围骨折的治疗策略
- Author:
Pengde KANG
1
;
Donghai LI
;
Fuxing PEI
Author Information
1. Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu 610041, China
- Publication Type:Review
- From:
Chinese Journal of Orthopaedics
2019;39(15):961-972
- CountryChina
- Language:Chinese
-
Abstract:
Periprosthetic femoral fracture (PFF) is one of severe complications after total hip arthroplasty (THA). As the number of patients receiving THA increased recently, the incidence of PFFs also increased dramatically. There are a number of risk factors for PFFs, such as age, sex, falling and prosthesis loosening. The Vancouver classification system is the most commonly used classification method for PFFs. According to the fracture location, PFFs can be divided into type A intertrochanteric fracture, type B fracture around the stem and type C fracture beyond the stem. The Vancouver type B PFF is further subdivided into type B1 with a well-fixed prosthesis, type B2 with a loose prosthesis but with adequate bone stock, and type B3 with a loose prosthesis and poor proximal bone stock simultaneously. Currently, there are some controversies in treating PFFs, mainly including whether the stem is fixed or not, whether the prosthesis needs to be revised, the selection of the stem, the reconstruction of bone defects, and the methods of fracture fixation. We searched literatures related to PFFs after THA. The incidence, risk factors, classification methods, treatment principles and strategies of PFFs were summarized in the present study. Based on our long-term clinical experience, we evaluated the advantages and disadvantages of each treatment method and provided considerations for the clinical research and selection in treating PFFs.
