Causes of failure in periprosthetic fractures of the hip at 1- to 14-year follow-up
| Autor: | Alessandro Canella, Mauro Spina, Andrea Scalvi, Guido Rocca |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Reoperation
medicine.medical_specialty Vancouver classification Time Factors Arthroplasty Replacement Hip medicine.medical_treatment Periprosthetic Risk Assessment Prosthesis Fracture Fixation Internal Fracture fixation medicine Humans Treatment Failure General Environmental Science Fracture Healing Osteosynthesis business.industry Mortality rate Surgery Radiography Harris Hip Score Radiological weapon General Earth and Planetary Sciences Periprosthetic Fractures business Follow-Up Studies |
| Zdroj: | Injury. 45:S85-S92 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2014.10.029 |
| Popis: | Introduction The results and causes of failure for 61 patients undergoing surgery for femoral hip periprosthetic fracture are reported. Materials and methods Fractures were classified according to the Vancouver System. Osteosynthesis was performed in 88% of cases and prosthetic revision in 12% of cases. Clinical and functional outcomes were assessed according to the Harris Hip Score and radiological results were evaluated using Beals and Tower's criteria. Results At a mean follow-up of 32 months, the Harris Hip Score was 73.1 and the radiological results were excellent-to-good in 72.2% of patients after the first surgery. At the end of treatment, complete healing of the fracture and stability of the prosthesis was found in 87.3% of patients. The most relevant result was the recovery of walking in 73.8% of patients. Mortality after surgery was 1.6% at 3 months and 3.3% at 12 months. A higher mortality rate occurred when surgery was delayed more than 5 days after trauma. Conclusions The analysis of our cases shows that in Vancouver type B1 fractures treated with plating osteosynthesis, there were worse outcomes in total hip arthroplasty with cemented stems compared with uncemented stems. In Vancouver type B2 fractures with cementless straight stems, osteosynthesis with a plate can be a valid option. In Vancouver type C fractures, the stability of the stem must be carefully assessed. |
| Databáze: | OpenAIRE |
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