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Year : 2015  |  Volume : 28  |  Issue : 4  |  Page : 971-977

Intraoperative periprosthetic hip fractures

Department of Orthopaedics and Trauma, Shebeen El-Kom Medical School, Menoufia University, Shebeen El-Kom, Menoufia Governorate, Egypt

Correspondence Address:
Ahmed E. E. Ahmed
6th Floor, No. 7, Dr Lasheen St. off King Faysal St., Haram, Giza, 12814
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.173691

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Purpose The aim of this work was to study the risk factors, clinical results, particularly the functional outcome, and radiological results for intraoperative periprosthetic fractures (PPFs) around hip arthroplasties through a retrospective analysis. Materials and methods We conducted a retrospective study based on hospital records. Patients with intraoperative PPFs around hip arthroplasties who underwent follow-up for at least 9 months were enrolled in the study. For each patient, preoperative and intraoperative risk factors were analyzed; the functional outcome in terms of the Harris hip score was compared before fracture and at the last follow-up. Results Fifteen cases were enrolled in this study. Six male and nine female patients were included with a mean ± SD age of 57.2 ± 8.5 years. A mean follow-up of 15.2 months was achieved. The average Harris hip score at the last follow-up was 85.7 points. All cases obtained primary bony union. The mean time from surgery to bony union was 8.3 months, ranging 3-12 months. Conclusion Female patients are at a higher risk of intraoperative PPF; in addition, significant femoral deformity and osteopenia are estimated risk factors. Cortical perforations and bone defects along with previously existing osteotomies are the other risk factors. Revision surgeries, cementless components, straight long stem, and vigorous manipulation of the femur are the surgery-related risk factors detected. Component stability is the most important factor for intraoperative decision-making. Extended trochanteric osteotomy is a safe and useful procedure, especially when using long straight stems. In addition, the use of supplementary cerclage fixation of fracture fragments for Vancouver B fractures yields better results.

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