Abstract:

BACKGROUND: The treatment for the periprosthetic femoral fracture following hip arthroplasty is difficult because of the metal prosthesis and the quality of local bone loss, and the appropriate treatment remains controversial.
OBJECTIVE: To discuss an accurate preoperative planning and clinical effects according to the periprosthetic femoral fracture following hip arthroplasty.
METHODS: A total of 9 patients with periporsthetic femoral fractures were treated in First Department of Orthopedics, First Affiliated Hospital of Xinjiang Shihezi University Medical School from February 2001 to June 2009 and were retrospectively reviewed. The patients were classified by Vancouver classification, including 1 case of A-type fracture, 3 of B1-type fracture, 4 of B2-type fracture and 1 of C-type fracture. The option of treatments included the conservative treatment, open reduction with internal fixation of wire or plate, long stem revision with wire, and the clinical effects and complications of those treatments were observed.
RESULTS AND CONCLUSION: All the patients were followed for 1.1-4.5 years with a mean follow-up of 2.5 years; 6 patients received postoperative fracture healing and the average healing time was 6 months. Two B2-type fracture cases of long stem revision with wire and one C-type fracture case with internal fixation of plate were not healed. The key of the treatments applied for periprosthetic fractures is to select the appropriate therapy according to the site of fracture, stability of implant and quality of bone and prevention of the blood circulation of fracture.