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Outcomes following osteosynthesis of periprosthetic hip fractures around cemented tapered polished stems
Affiliation:1. Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany;2. Department of Knee and Shoulder Surgery, Sports Traumatology, Asklepios Clinic St. Georg, Hamburg, Germany;3. "Fracture Committee" of the German Knee Society, Germany;1. Department of Orthopaedic Surgery, Gyeongsang National University, College of Medicine, Gyeongsang National University Changwon Hospital, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, Gyeongsangnam-do, 51472, Republic of Korea;2. Department of Orthopedic Surgey, Samsung Changwon hospital, Sungkyunkwan University, school of medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si, Gyeongsangnam-do, 51353, Republic of Korea;1. Hip Injury Department, Henan Provincial Luoyang Orthopedic Hospital, Luoyang City, China;2. Department of Orthopedic Surgery, University of Colorado, Denver Health Medical Center, Denver, CO, USA
Abstract:
We retrospectively reviewed outcomes of 79 patients with periprosthetic hip fractures around cemented tapered polished stem (CTPS) implants treated with osteosynthesis between January 1997 and July 2011. All patients underwent open reduction and fixation using a broad dynamic compression plate (DCP).Seventy two (91%) of fractures united. There were seven (9%) non-unions with failure of metal work, three (4%) as a result of infection and four (5%) due to mechanical failure. Significant subsidence (>5 mm) of the implant was seen in seven (9%) of cases. Ten (13%) cases developed post-operative infection. Non-anatomic reduction and infection were identified as predictors of poor outcome.This is the largest series of a very specific group of periprosthetic fractures treated with osteosynthesis. Open reduction internal fixation with a broad dynamic compression plate for patients with periprosthetic hip fractures around the tip of cemented tapered polished stems is a suitable treatment provided there is no bone loss and the fracture can be precisely, anatomically, reduced and adequately fixed.
Keywords:Periprosthetic hip fracture  Osteosynthesis
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