Long-term outcomes and complications of Periprosthetic Fractures of the Proximal Femur: A Retrospective Review of 48 Patients
Abstract
Objectives: Periprosthetic fractures, especially periprosthetic proximal femur fractures, are an increasingly important orthopaedic problem. The aim of this study is to evaluate long-term results, mortality and complications of periprosthetic fractures.
Methods: Patients who had proximal femur periprosthetic fracture were evaluated retrospectively. Patients with Vancouver type B1 and C were treated with plate-screw osteosynthesis and patients with Vancouver type B2 were operated using revision femoral systems. Follow-up was evaluated by clinical and radiographic, and functional results were assessed by Gos scoring.
Results: Totally 48 patients were evaluated retrospectively. 16 patients (33.3%) were type B1, 18 patients (37.5%) were type B2 and 14 patients (29.2%) were type C. 30 patients (62.5%) with type B1 and C were treated with plate screw osteosynthesis and 18 patients (37.5%) with type B2 treated with revision femoral systems. There was a significant correlation between the surgical method applied and both mortality and preop/postop GOS scoring systems (p <0.05). Complications and/or the need for intensive care were seen in 28 patients (58.3%) only 1(2.1%) of these was due to iatrogenic. In total, 20 patients (41.7%) from 48 patients could complete the procedure without any problems.
Conclusion: As a result of our study, 58% of patients with periprosthetic femur fractures had complications and need intensive care during the treatment process. Periprosthetic proximal femur fractures, which are generally seen in the elderly population, are injuries with very high complication, mortality and morbidity rates. Therefore, it is recommended that surgeons pay maximum attention during the treatment process.
Keywords
Periprosthetic Femur Fracture Long-term Results Glasgow Outcome Scale (GOS) Mortality Complications
References
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- 2. Lindahl H, Garellick G, Regner H, et al. Three hundred and twenty-one periprosthetic femoral fractures. J Bone Joint Surg Am 2006; 88: 1215.
- 3. Bhattacharyya T, Chang D, Meigs JB, et al. Mortality after periprosthetic fracture of the femur. J Bone Joint Surg Am 2007; 89: 2658.
- 4. Pavlou G, Pantaliadis P, Macdonald D, Timperley JA, Gie G, Bancroft G, et al. A review of 202 periprosthetic fractures, stem revision and allograft improves outcome for type B fractures. Hip Int 2011; 21: 21–29.
- 5. Park, J. S., Hong, S., Nho, J. H., Kang, D., Choi, H. S., & Suh, Y. S. (2019). Radiologic outcomes of open reduction and internal fixation for cementless stems in Vancouver B2 periprosthetic fractures. Acta orthopaedica et traumatologica turcica, 53(1), 24-29.
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Abstract
References
- 1. Lindahl H. Epidemiology of periprosthetic femur fracture around total hip arthroplasty. Injury 2007; 38: 651–654.
- 2. Lindahl H, Garellick G, Regner H, et al. Three hundred and twenty-one periprosthetic femoral fractures. J Bone Joint Surg Am 2006; 88: 1215.
- 3. Bhattacharyya T, Chang D, Meigs JB, et al. Mortality after periprosthetic fracture of the femur. J Bone Joint Surg Am 2007; 89: 2658.
- 4. Pavlou G, Pantaliadis P, Macdonald D, Timperley JA, Gie G, Bancroft G, et al. A review of 202 periprosthetic fractures, stem revision and allograft improves outcome for type B fractures. Hip Int 2011; 21: 21–29.
- 5. Park, J. S., Hong, S., Nho, J. H., Kang, D., Choi, H. S., & Suh, Y. S. (2019). Radiologic outcomes of open reduction and internal fixation for cementless stems in Vancouver B2 periprosthetic fractures. Acta orthopaedica et traumatologica turcica, 53(1), 24-29.
- 6. Gülşen, M., Karatosun, V., & Uyulgan, B. (2011). The biomechanical assessment of fixation methods in periprosthetic femur fractures. Acta orthopaedica et traumatologica turcica, 45(4), 266-269.
- 7. Dennis MG, Simon JA, Kummer FJ, Koval KJ, Di Cesare PE. Fixation of periprosthetic femoral shaft fractures: a biomechanical comparison of two techniques. J Orthop Trauma 2001; 15: 177–180
- 8. Dennis MG, Simon JA, Kummer FJ, Koval KJ, DiCesare PE. Fixation of periprosthetic femoral shaft fractures occurring at the tip of the stem: a biomechanical study of 5 techniques. J Arthroplasty 2000; 15: 523–528.
- 9. Fulkerson E, Tejwani N, Stuchin S, Egol K. Management of periprosthetic femur fractures with a first-generation locking plate. Injury 2007; 38: 965–972.
- 10. Kurtz S, Ong K, Lau E, Mowat F, HalpernM (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89: 780–785.
- 11. McLauchlan GJ, Robinson CM, Singer BR, Christie J. Results of an operative policy in the treatment of periprosthetic femoral fracture. J Orthop Trauma 1997; 11: 170–179
- 12. Parvizi J, Rapuri VR, Purtill JJ, Sharkey PF, Rothman RH, Hozack WJ. Treatment protocol for proximal femoral periprosthetic fractures. J Bone Joint Surg Am 2004; 86-A: 8–16
- 13. Berry DJ. Treatment of Vancouver B3 periprosthetic femur fractures with a fluted tapered stem. Clin Orthop Relat Res 2003; 417: 224–231
- 14. Corten K, Vanrykel F, Bellemans J, Frederix PR, Simon JP, Broos PL. An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component. J Bone Joint Surg Br 2009; 91: 1424–1430.
- 15. Springer BD, Berry DJ, Lewallen DG. Treatment of periprosthetic femoral fractures following total hip arthroplasty with femoral component revision. J Bone Joint Surg Am 2003; 85-A: 2156–2162.
- 16.Ruchholtz S, El-Zayat B, Kreslo D, Bücking B, Lewan U, Krüger A, Zettl R. Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur--a prospective study of 41 patients. Injury. 2013 Feb;44(2):239-48.
- 17. Lampropoulou-Adamidou K, Tosounidis TH, Kanakaris NK, Ekkernkamp A, Wich M, Giannoudis PV. The outcome of Polyax Locked Plating System for fixation distal femoral non-implant related and periprosthetic fractures. Injury. 2015 Nov;46 Suppl 5:S18-24.
- 18. McMillan T, Wilson L, Ponsford J, Levin H, Teasdale G, Bond M. The Glasgow Outcome Scale - 40 years of application and refinement. Nat Rev Neurol. 2016 Aug;12(8):477-85.
- 19. Langenhan R, Trobisch P, Ricart P, Probst A. Aggressive surgical treatment of periprosthetic femur fractures can reduce mortality: comparison of open reduction and internal fixation versus a modular prosthesis nail. J Orthop Trauma 2012; 26: 80–85.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics |
| Journal Section | Research Article |
| Authors | |
| Publication Date | October 1, 2022 |
| Submission Date | April 8, 2022 |
| Published in Issue | Year 2022Volume: 13 Issue: 4 |
