Fractures of the ipsilateral femur after total hip arthroplasty

Abstract

The aim of this study was to investigate the predisposing factors, fracture location, treatment, and final outcome of femoral fractures after total hip arthroplasty (THA). From 1975 to 1983, 28 patients were seen with 29 fractures on the same side as the prosthesis. Most of the fractures were caused by minor trauma, and prior hip surgery was the most common predisposing factor. Two patients underwent early operation and six were treated with protected weight bearing. Twenty-one underwent initial skeletal traction, and 14 of these fractures united without further surgery. Six of the patients treated with initial skeletal traction were operated on early, mainly by osteosynthesis, due to poor fracture alignment. Three of these fractures united, but one subsequently required revision arthroplasty because of loosening of the femoral component. Two patients died and three had a permanent pseudarthrosis or a Girdlestone resection. Nineteen of the 21 fractures not operated on united and five of the eight operated united. The results indicate that when good fracture alignment is achieved with traction, union is not jeopardized by either the prosthesis or the cement.

Uncemented revision stem for biological osteosynthesis in periprosthetic femoral fractures

“…Conservative treatment of periprosthetic fracture is recommended by several authors in order to avoid damaging the periosteal blood supply and to avoid operative trauma [1,11,15]. Some surgeons achieve stabilisation by using plates, cerclage wiring or Parham bands [4], and this may be suitable when there is no loosening of the femoral stem and no comminution [3].…”

“…Different procedures for treating femoral fractures after THR have been reported, including casting or skeletal traction, plating or cerclage wiring with or without bone grafting, and implantation of long stemmed prostheses [1,3,15,18,19]. When the prosthesis is loose and there are bony defects, the implantation of cemented long stemmed components combined with plating may be needed to achieve stability.…”

Management of Vancouver B2 and B3 femoral periprosthetic fractures using a modular cementless stem without allografting

“…They are a major complication of hip arthroplasty that pose a big challenge to reconstructive orthopaedic surgeons. Both nonsurgical and surgical management options have been described in the literature [1][2][3][4][5][6][7][8][9][10][11].These fractures must be treated according to their individual characteristics, implant status, associated medical conditions, and each patient's level of physical activity [1,2,12]. Several classifications have been used in the literature [1,2,4,5,[12][13][14].…”

Irreducible subtrochanteric fractures treated by open reduction and internal fixation with cables and proximal femoral nailing

“…[4][5][6] The aim is therefore to verify, on the base of the case studies available, the long-term results for surgical treatment of fractures after THA. Although serious injury is a public health priority in the UK, there appears to be a lack of information available on population-based rates of serious injury as defined by a recognized severity of injury taxonomy.…”