Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 25373
SURGICAL TREATMENT IN PROXIMAL FEMORAL PERIPROSTHETIC
FRACTURES
Tudor SORIN POP, Istvan GERGELY, Octav RUSSU, Ors NAGY
Universitary Clinic of Orthopaedics and Traumatology, Targu Mures (ROMANIA)
Background: Fracture around the femoral stem is a serious complication of total hip
arthroplasty, which is now on the rise. Such fractures can range from being minor,
with minimal or no effect on the outcome, to being catastrophic and possibly creating
an unreconstructable problem with an immense effect on the patient's function.
Material and methods: 34 patients with periprosthetic proximal femoral fractures, 23
men and 11 women, with a mean age of 61.4 years were included in this study.
According to Vancouver classification system 15 fractures were type B1, 9 type B2, 4
type B3 and 6 type C. In cases associated with a well fixed stem (B1, C) we used
internal fixation with cerclage wires or cables, screws and plates. All types of
fractures associated with a loose femoral component (B2, B3) were treated by a
revision arthroplasty using a long femoral stem inserted with or without cement,
combined in 4 cases with cancellous bone-grafting. Results: The fractures healed
between 10 to 24 weeks (average, 15.6 weeks). At the time of the latest follow-up
(mean, 3.5 years), all patients were able to walk and had minimal or no pain, with
good functional results. There were no non-unions, malunions or
infections.Conclusion: Periprostethic femoral fractures can be managed by a wide
variety of treatment options. Classification of the fractures with a correct evaluation of
its location, fixation of the stem and bone quality allows a rational choice of
reconstructive options.
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