Proximal femoral fractures following total hip arthroplasty.

  • 1 October 1982
    • journal article
    • No. 170,p. 95-106
Abstract
Thirty-one postoperative fractures around the femoral component of previous total hip arthroplasties were reviewed retrospectively until healing occurred. This type of injury seemed to be associated with either high-velocity trauma or weakening of bony stock secondary to stress risers from prior surgery or loosening. These fractures were classified as Type A at the stem tip, Type B spiralling around the stem, and Type C comminuted around the stem. Type A fractures have a significant incidence of nonunion in the face of multiple previous proximal femoral surgeries, but, after healing, usually show no loosening. Type B fractures usually will heal without operative intervention but have a high incidence of associated eventual component loosening. Type C fractures need immediate surgery to allow mobilization of the elderly patient. When postfracture revision surgery with long-stem component or plating is required, the technical order of priority should be adequate bony apposition of fracture fragments, good cement technique at the proximal femur, bone grafting.

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