RT Journal Article
SR Electronic
T1 Outcomes following surgical treatment of periprosthetic femur fractures: a single centre series
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 209
OP 213
DO 10.1503/cjs.014813
VO 57
IS 3
A1 Natasha Holder
A1 Steve Papp
A1 Wade Gofton
A1 Paul E. Beaulé
YR 2014
UL http://canjsurg.ca/content/57/3/209.abstract
AB Background: Periprosthetic femoral fracture after total hip arthroplasty (THA) is an increasing clinical problem and a challenging complication to treat surgically. The aim of this retrospective study was to review the treatment of periprosthetic fractures and the complication rate associated with treatment at our institution.Methods: We reviewed the cases of patients with periprosthetic femoral fractures treated between January 2004 and June 2009. We used the Vancouver classification to assess fracture types, and we identified the surgical interventions used for these fracture types and the associated complications.Results: We treated 45 patients with periprosthetic femoral fractures during the study period (15 men, 30 women, mean age 78 yr). Based on Vancouver classification, 2 patients had AL fractures, 9 had AG, 15 had B1, 24 had B2, 2 had B3 and 4 had C fractures. Overall, 82% of fractures united with a mean time to union of 15 (range 2–64) months. Fourteen patients (31%) had complications; 11 of them had a reoperation: 6 to treat an infection, 6 for nonunion and 2 for aseptic femoral component loosening.Conclusion: Periprosthetic fractures are difficult to manage. Careful preoperative planning and appropriate intraoperative management in the hands of experienced surgeons may increase the chances of successful treatment. However, patients should be counselled on the high risk of complications when presenting with this problem.