Outcomes Following Surgical Treatment of Periprosthetic Femur Fractures: a Single Centre Series

Overview

Journal Can J Surg

Specialty General Surgery

Date 2014 May 30

PMID 24869614

Citations 12

Authors

Natasha Holder

Steve Papp

Wade Gofton

Paul E Beaule

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

The History of Classification Systems for Periprosthetic Femoral Fractures: A Literature Review.

Yao Z, Fan S, Wei-Qiang Zhao , Huang J Orthop Surg. 2024; 16(8):1816-1831.

PMID: 38946014 PMC: 11293929. DOI: 10.1111/os.14149.

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis.

Yoon B, Park S, Roh Y Hip Pelvis. 2023; 35(4):217-227.

PMID: 38125267 PMC: 10728046. DOI: 10.5371/hp.2023.35.4.217.

Drilling the cement mantle in well-fixed periprosthetic femur fractures is not associated with arthroplasty-related complications.

Van Rysselberghe N, DeBaun M, Sanchez M, Wadhwa H, Pfaff K, Bellino M Eur J Orthop Surg Traumatol. 2022; 33(5):1629-1633.

PMID: 35788424 DOI: 10.1007/s00590-022-03308-w.

Periprosthetic joint infection is the main reason for failure in patients following periprosthetic fracture treated with revision arthroplasty.

van den Kieboom J, Tirumala V, Xiong L, Klemt C, Kwon Y Arch Orthop Trauma Surg. 2021; 142(12):3565-3574.

PMID: 33991236 DOI: 10.1007/s00402-021-03948-3.

Results after surgical treatment of periprosthetic proximal femoral fractures. Osteosynthesis with prosthesis preservation vs. prosthesis change.

Zajonz D, Ponick C, Edel M, Mobius R, Pfeifle C, Prietzel T GMS Interdiscip Plast Reconstr Surg DGPW. 2020; 9:Doc02.

PMID: 33214984 PMC: 7656975. DOI: 10.3205/iprs000146.

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