Gaetano Caruso1, Lorenzo Milani2, Tedi Marko2, Vincenzo Lorusso2, Mattia Andreotti2, Leo Massari2. 1. Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara - Arcispedale Sant'Anna, University of Ferrara, Via Aldo Moro, 8, 4124, Ferrara, Italy. crsgtn@unife.it. 2. Department of Biomedical and Specialty Surgical Sciences, Azienda Ospedaliero-Universitaria di Ferrara - Arcispedale Sant'Anna, University of Ferrara, Via Aldo Moro, 8, 4124, Ferrara, Italy.
Abstract
BACKGROUND: The treatment of periprosthetic femoral fractures is a great challenge for the orthopedic surgeon and requires a knowledge of bone fracture fixation as well as skills and experience in revision surgery. The aim of this retrospective study was to evaluate the functional and radiological outcomes of periprosthetic femoral fractures surgically treated in our department from 2010 to 2016. MATERIALS AND METHODS: This study involved 73 patients with a periprosthetic femoral fracture after total hip arthroplasty or hemiarthroplasty. Periprosthetic femoral fractures were classified using the Vancouver system. Functional outcomes were assessed using Harris hip score, Palmer Parker score, SF-36 score and ambulatory status. Radiological findings were classified using Beals and Tower's criteria. RESULTS: The mean age of patients was 79.6 years old. Local risks factors were identified in 67% of the patients, principally osteoporosis (63.0%), followed by osteolysis (26.0%) and loosening of the stem (8.2%). According to the Vancouver classification, there were 10 type A, 49 type B and 14 type C fractures. Of the type B fractures, 26 were B1, 17 were B2 and 6 were B3. Applying Beals and Tower's criteria, radiological results were excellent in 24 patients (32.9%), good in 35 (47.9%) and poor in 14 (19.2%). The mean Harris hip score post-operatively was 72.5. CONCLUSIONS: These kinds of fractures should be assessed individually and the optimal treatment plan should be made in accordance with the bone stock quality, stem stability, location of the fracture and patient expectations.
BACKGROUND: The treatment of periprosthetic femoral fractures is a great challenge for the orthopedic surgeon and requires a knowledge of bone fracture fixation as well as skills and experience in revision surgery. The aim of this retrospective study was to evaluate the functional and radiological outcomes of periprosthetic femoral fractures surgically treated in our department from 2010 to 2016. MATERIALS AND METHODS: This study involved 73 patients with a periprosthetic femoral fracture after total hip arthroplasty or hemiarthroplasty. Periprosthetic femoral fractures were classified using the Vancouver system. Functional outcomes were assessed using Harris hip score, Palmer Parker score, SF-36 score and ambulatory status. Radiological findings were classified using Beals and Tower's criteria. RESULTS: The mean age of patients was 79.6 years old. Local risks factors were identified in 67% of the patients, principally osteoporosis (63.0%), followed by osteolysis (26.0%) and loosening of the stem (8.2%). According to the Vancouver classification, there were 10 type A, 49 type B and 14 type C fractures. Of the type B fractures, 26 were B1, 17 were B2 and 6 were B3. Applying Beals and Tower's criteria, radiological results were excellent in 24 patients (32.9%), good in 35 (47.9%) and poor in 14 (19.2%). The mean Harris hip score post-operatively was 72.5. CONCLUSIONS: These kinds of fractures should be assessed individually and the optimal treatment plan should be made in accordance with the bone stock quality, stem stability, location of the fracture and patient expectations.
Entities:
Keywords:
Harris hip score; Outcome; Periprosthetic femoral fractures; Surgical treatment
Authors: Clemens Kösters; Daniel den Toom; Sven Märdian; Steffen Roßlenbroich; Sebastian Metzlaff; Kiriakos Daniilidis; Jens Everding Journal: J Clin Med Date: 2022-02-23 Impact factor: 4.241