Clin Orthop Surg.  2011 Jun;3(2):101-106. 10.4055/cios.2011.3.2.101.

Treatment of Periprosthetic Femoral Fractures in Hip Arthroplasty

Affiliations
  • 1Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea. syukim@knu.ac.kr

Abstract

BACKGROUND
We analyzed the radiological and clinical results of our study subjects according to the management algorithm of the Vancouver classification system for the treatment of periprosthetic femoral fractures in hip arthroplasty.
METHODS
We retrospectively reviewed 18 hips with postoperative periprosthetic femoral fractures. The average follow-up was 49 months. The fracture type was determined based on the Vancouver classification system. The management algorithm of the Vancouver classification system was generally applied, but it was modified in some cases according to the surgeon's decision. At the final follow-up, we assessed the radiological results using Beals and Tower's criteria. The functional results were also evaluated by calculating the Harris hip scores.
RESULTS
Seventeen of 18 cases (94.4%) achieved primary union at an average of 25.5 weeks. The mean Harris hip score was 92. There was 1 case of nonunion, which was a type C fracture after cemented total hip arthroplasty, and this required a strut allograft. Subsidence was noted in 1 case, but the fracture was united despite the subsidence. There was no other complication.
CONCLUSIONS
Although we somewhat veered out of the management algorithm of the Vancouver classification system, the customized treatment, with considering the stability of the femoral stem and the configuration of the fracture, showed favorable overall results.

Keyword

Periprosthetic femoral fractures; Hip arthroplasty; Vancouver classification system

MeSH Terms

Adult
Aged
Aged, 80 and over
Algorithms
Arthroplasty, Replacement, Hip/*adverse effects
Female
Femoral Fractures/*classification/radiography/*surgery
Humans
Male
Middle Aged
Periprosthetic Fractures/*classification/radiography/*surgery
Practice Guidelines as Topic
Retrospective Studies
Treatment Outcome

Figure

  • Fig. 1 (A) A Vancouver type B2 periprosthetic femoral fracture. (B) A radiograph showing union at 3 months follow-up after revision and augmentation with an allograft.

  • Fig. 2 (A) A Vancouver type C periprosthetic femoral fracture. (B) A radiograph showing nonunion with varus deformity at 10 months follow-up after open reduction and internal fixation with a plate. (C) Fracture union was identified at 4 months after revision with a cortical strut allograft.


Cited by  4 articles

Antibiotic-impregnated Cement Plate for the Treatment of Infected Periprosthetic Femoral Fracture after Cementless Total Hip Arthroplasty - A Case Report -
Han-Jun Lee, Jong Won Kim, Jae-Sung Lee, Kwang-Sup Song, Yong-Chan Ha, Min Kyu Kim
Hip Pelvis. 2012;24(3):245-249.    doi: 10.5371/hp.2012.24.3.245.

Could Patient Undergwent Surgical Treatment for Periprosthetic Femoral Fracture after Hip Arthroplasty Return to Their Status before Trauma?
Long Zheng, Woo-Yong Lee, Deuk-Soo Hwang, Chan Kang, Chang-Kyun Noh
Hip Pelvis. 2016;28(2):90-97.    doi: 10.5371/hp.2016.28.2.90.

The Result of Revision Total Hip Arthroplasty in Patients with Metallosis Following a Catastrophic Failure of a Polyethylene Liner
Hong Suk Kwak, Jeong Joon Yoo, Young-Kyun Lee, Kyung-Hoi Koo, Kang Sup Yoon, Hee Joong Kim
Clin Orthop Surg. 2015;7(1):46-53.    doi: 10.4055/cios.2015.7.1.46.

Prognostic Factors and Clinical Outcomes after Treatment of Periprosthetic Femoral Fractures Using a Cable-plate
Joon Soon Kang, Kyoung-Ho Moon, Bong Sung Ko, Tae Hoon Roh, Yeop Na, Yung-Hun Youn, Joo Hyun Park
Hip Pelvis. 2019;31(3):166-173.    doi: 10.5371/hp.2019.31.3.166.


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