Abstract
Aims: The purpose of this study was to analyze treatment of postoperative femoral periprosthetic fractures at the Institute for orthopedic surgery ÒBanjicaÒ. Methods: There were 26 patients included in this study. Twenty-one case was of periprosthetic fracture after total hip replacement and in 5 patients there was a femoral fracture after total knee replacement. Fractures were classiþed as: type A Ð prosthesis and fracture stable; type B Ð prosthesis stable and fracture unstable; type C Ð prosthesis and fracture unstable, adequate bone stock; and type D Ð prosthesis and fracture unstable, inadequate bone stock. Functional assessment was made using the modiþed Harris score. Results: Follow up period ranged from 2 to 9 years with a mean of 3.2 years. Time spent from premier procedure till fracture averaged 2.5 years with range from 3 months to 6 years. In 14 cases treatment consisted of prostethic revision with longer cemented stem and in 10 fracture þxation was done using plate and screw and/or wire þxation. 2 patients went on for nonoperative treatment. Cortical allografts were used in 4 cases. 18 out of 26 patients returned to preinjury level of function as assessed by Harris hip score. Conclusions: Analysis conþrmed two basic principles in the treatment of periprosthetic femoral fractures: 1) Unstable and loose stems should be replaced with longer stems that would provide implant and fracture stability and 2) Displaced fractures should be stabilized.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
