Intraoperative Fractures: Rising Problems

Abstract

All hip surgeons have had the experience of completing a primary total hip arthroplasty (THA) only to discover a proximal femoral fracture just prior to reducing the hip. We can comfort our patients and ourselves that the outcome of a THA with a proximal femoral fracture is excellent with proper treatment and uncemented stem fixation. The purpose of this study was to examine risk fractures, treatment options, and outcomes in THA with proximal femoral fractures. Fracture Risk Factors As the number of uncemented THAs has increased,1,2 there is no question the incidence of uncemented stem fractures has increased as as well.3 The risks for fracture during THA have been well studied. In their study, Schwartz et al4 found women were at higher risk for proximal femoral fracture with the AML stem (DePuy, Warsaw, Ind). Changes in instrumentation and implantation have helped reduce the risk of fracture. Berend et al5 noted higher fracture rates in hips undergoing THA for a diagnosis other than osteoarthritis.

Rejecting Renvoi for Movable Cultural Property: The Islamic Republic of Iran v. Denyse Berend

“…He recognized that there may be "a number of reasons why it might be desirable to apply [renvoi ] generally, in dealing with national treasures or monuments, the law of the state of origin, but that is a matter for governments to determine and implement if they see fit." 33 Renvoi was originally designed to foster consistency across jurisdictions. However, Justice Eady found the argument by Justice Millett in Macmillan particularly relevant.…”