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Type: Journal article
Title: Periprosthetic femoral fractures after total hip arthroplasty
Author: Young, Simon W.
Pandit, Salil
Munro, Jacob Terrill
Pitto, Rocco P.
Citation: Australian and New Zealand Journal of Surgery, 2007; 77(6):424-428
Publisher: Blackwell Science Asia
Issue Date: 2007
ISSN: 1445-1433
School/Discipline: Orthopaedics and Trauma
Statement of
Simon W. Young, Salil Pandit, Jacob T. Munro and Rocco P. Pitto
Abstract: BACKGROUND: The management of periprosthetic fracture following a total hip arthroplasty is difficult, requiring expertise in both trauma and revision surgery. With rising numbers of patients in the population living with hip prostheses in situ, the frequency of these fractures is increasing, and controversy remains over their ideal management. The objective of this study was to review all periprosthetic fractures at a single institution to identify injury and treatment patterns and their associated clinical outcomes. METHODS: Fifty-four periprosthetic fractures in 50 patients were reviewed to determine the relative frequency of fracture types, their complication rates and the clinical outcomes. Patient data were obtained through review of the clinical notes and individual patient follow up. Clinical outcomes were evaluated using the Oxford Hip Score and Harris Hip Score. RESULTS: The 54 fractures were classified using the Vancouver system, most of which were type B1 (20) or type B2 (10). The mean time to union for all fracture types was 4.6 months. A high non-union rate was seen among fractures fixed operatively. Fifteen per cent of fractures went on to develop loosening following treatment, suggesting an underrecognition at the time of injury. The average Harris Hip Score was 73.1 and Oxford Hip Score 30.3 for all fracture types at a mean follow up of 3.3 years. In the 15 patients treated with revision surgery, the most common complication was dislocation (27%). CONCLUSION: Treatment of patients with periprosthetic fractures requires recognition of the challenging nature of these injuries, the associated poor prognosis and the high complication rate.
Keywords: Fracture; periprosthetic; prosthesis loosening; revision; total hip arthroplasty
Rights: © 2007 Royal Australasian College of Surgeons
DOI: 10.1111/j.1445-2197.2007.04087.x
Appears in Collections:Orthopaedics and Trauma publications

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