Die versorgung von femurfrakturen bei hüftendoprothese

Between 1995 and 1997 we operated 24 patients with implanted hip prosthesis and periprosthetic fractures of the proximal femur using a revision-prosthesis with elastic stem. In 6 patients we performed a primary revision due to aseptic loosening and massive bone loss. In 5 cases fractures occurred intraoperatively during prosthesis revisions, in 6 cases fractures of the prosthesis and/or femur existed preoperatively and in 5 patients we saw pathologic femur fractures. In one patient we performed an osteotomy and correction of the femur axis during prosthesis revision and in another patient we removed a broken stem caused by femur pseudarthrosis. No acetabular revision had to be performed. The used prosthesis stem (ESKA-Implants, Lübeck) was made of a proximal massive and a distal elastic part with the possible interlocking screw placement. During postoperative mobilisation partial weight bearing was allowed for 3 months, then full weight bearing was aimed after removal of the interlocking screws. In all treated patients we saw a good prosthesis ingrowth. We present the elastic stem as good implant, especially in case of femur fractures or bone stock loss.