092 TREATMENT OF FEMORAL PERIPROSTHETIC FRACTURES AFTER TKR AND THA AT A PROVINCIAL HOSPITAL – 8 YEARS EXPERIENCE

Abstract

Periprosthetic fractures represent a challenging problem in joint arthroplasty the incidence of which seems to be increasing due to the big number of the arthroplasties and the increasing average life expectancy.

The purpose of this study is to present the methods of treatment, the problems that we have to solve intra-operatively and our long term results about the healing procedure and the fuctional restoration.

Between 2000–2008 we operated 15 femoral peri-prosthetic fractures(1 re-fracture). 10 of them were after hip arthroplasties.

The classification which used was Lewis-Rorabeck for the fractures after TKR and Vancouver for them after THA.

Cause of fracture was fall and the time interval from the primary operation was 1–14 years. The majority of the patients were women(14), and the mean age 65 years.

13 of the 15 fractures were treated with ORIF and the remaining two need to be revised. During the follow up 2 of them died due to other pathological problems. The post op follow up ranged from 1–8(3.5)years.

The postoperative evaluation was done according the Harris Hip Score and the Knee Society Clinical Rating System.

The fractures healed after a mean time of 6 months. Two postoperative wound infections were registered to the revised fractures and their treatment were successful with surgical debridement.

All the patients are in good health condition, moving with some kind of support and they are selfreserved.

As a conclusion we believe that this kind of fractures demand the proper surgical planning, prediction of all possible complications and the cooperation of other specialties and physiotherapisties.