Abstract
Introduction and Objectives: The increase in hip replacement surgery in recent years as a consequence of the aging population and a greater demand placed on joints by our current lifestyle has caused an increase in related complications. The rate of intraoperative periprosthetic fractures is between 0.8 and 2.3%, and postoperative fracture rates reach 0.1% in some studies. This type of fracture is usually complex, and treatment is almost always quite difficult.
Materials and Methods: This study concentrates on peri-prosthetic hip fracture as a postoperative complication examining cases treated during the last 5 years. We have included cases of cemented and cementless partial and total arthroplasty. In this study, we did not include intra-operative fractures (secondary to surgical manipulation, as a result of reaming, cementing, or impaction of prosthetic components) because an irregular clinical history was associated with such cases, only reflecting those which required some type of synthesis, particularly cer-clage. The Johanson scale and the AAOS classification were used to classify fractures.
Results: Of 30 periprosthetic fractures recorded during the study period, 11 patients (36.7%) were males and 63.3% were female. Of fractures of the femoral diaphysis, more than half were Johanson Type II. Only one case involved the acetabulum. Nearly 17% required revision of some prosthetic component, and about one-third could be resolved orthopaedically. Of cases treated surgically, most complications were related to the surgical wound.
Discussion and Conclusions: The type of treatment used depends on various factors, such as type of fracture and fracture line, patient age, prosthetic loosening, etc. Individualised treatment is therefore the standard. We have observed no abnormalities in bone healing. Although this type of fracture is fortunately rare, we consider good preoperative planning and a thorough postoperative follow-up to be very important for the correct resolution of this difficult problem.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain
