title: Hoop-stress fractures of the proximal femur during hip arthroplasty. Management and results in 19 cases.
abstract: Retrospective review of 730 consecutive primary uncemented and cemented total hip arthroplasties revealed 19 intra-operative hoop-stress fractures of the femoral neck. These were incomplete, linear, and minimally displaced. Management was by cerclage wiring (12), bone graft and cerclage (two), further impaction (two), and the use of cement (three), with no change from our standard postoperative management and rehabilitation. Eighteen patients had excellent or good results with an average Harris hip score of 93. Radiographically, all but one patient had Engh stability-fixation scores consistent with stable bone ingrowth. We conclude that hoop-stress fractures of the proximal femur, properly managed, do not detract from the results of total hip arthroplasty.
authors.affiliation: Johns Hopkins University School of Medicine, Department of Orthopaedic Surgery, Baltimore, Maryland 21239.
authors.forename: M A
authors.initials: MA
authors.lastname: Mont
authors.forename: D C
authors.initials: DC
authors.lastname: Maar
authors.forename: K A
authors.initials: KA
authors.lastname: Krackow
authors.forename: D S
authors.initials: DS
authors.lastname: Hungerford
mesh_terms: D015142:Baltimore / Q000453:epidemiology; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D015775:Fractures, Stress / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies