Periprosthetic femoral fractures after hemiarthroplasty. An analysis of 17 cases

• Published in: Revista española de cirugía ortopédica y traumatología Vol. 59; no. 5; pp. 333 - 342
• Main Authors: Suárez-Huerta, M, Roces-Fernández, A, Mencía-Barrio, R, Alonso-Barrio, J A, Ramos-Pascua, L R
• Format: Journal Article
• Language: English
• Published: Spain 01.09.2015
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Female; Femoral Fractures - diagnosis; Femoral Fractures - etiology; Femoral Fractures - surgery; Follow-Up Studies; Fracture Fixation, Internal; Hemiarthroplasty; Humans; Male; Periprosthetic Fractures - diagnosis; Periprosthetic Fractures - etiology; Periprosthetic Fractures - surgery; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - surgery; Reoperation; Retrospective Studies; Risk Factors; Treatment Outcome; Fractura periprotésica; Clasificación de Vancouver; Femur; Fémur; Periprosthetic fracture; Hemiartroplastia; Vástago; Hemiarthroplasty; Stem; Vancouver classification
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2015.07.004

To describe the characteristics of patients with periprosthetic femoral fractures after hemiarthroplasty and analyze their treatment. An observational, longitudinal, retrospective study was conducted on a series of 17 patients with periprosthetic femoral fractures after hip hemiarthroplasty. Fourteen fractures were treated surgically. The characteristics of patients, fractures and treatment outcomes in terms of complications, mortality and functionality were analyzed. The large majority (82%) of patients were women, the mean age was 86 years and with an ASA index of 3 or 4 in 15 patients. Ten fractures were type B. There were 8 general complications, one deep infection, one mobilization of a non-exchanged hemiarthroplasty, and 2 non-unions. There were 85% consolidated fractures, and only 5 patients recovered the same function prior to the injury. At the time of the study 9 patients had died (53%). Periprosthetic femoral fractures after hemiarthroplasty will increase in the coming years and their treatment is difficult. Periprosthetic femoral fractures after hemiarthroplasty are more common in women around 90 years-old, and usually occur in patients with significant morbidity. Although the Vancouver classification is reliable, simple and reproducible, it is only a guide to decide on the best treatment in a patient often fragile. The preoperative planning is essential when deciding a surgical treatment.