Femoral shaft fracture after hip arthroplasty: a system for classification and treatment.
Twenty-one consecutive cases of femoral shaft fracture after hip arthroplasty treated at the University of Illinois affiliated hospitals were reviewed. Adequate follow-up and radiographs were available for 19 patients. The length of follow-up after fracture ranged from 2 to 13 years, with a mean of 3.1 years. The time from index procedure to fracture averaged 2.6 years, with a range of 10 days to 11 years. The primary femoral stem was cemented in 11 hips and cementless in 8 hips. Six patients were treated nonoperatively and 13 operatively. Three had fracture fixation with retention of a well-fixed prosthesis and 10 had prosthetic revision. Cortical allograft was used in 5 cases. Sixteen of the 19 patients returned to their prefracture level of function and ambulation. The factors important to treatment are fracture stability, implant stability, and adequacy of bone stock. A classification system based on these factors and recommendations for treatment are proposed.
Department of Orthopaedics, University of Illinois at Chicago and Cook County Hospital, Ill 60612, USA.
M H
MH
Gonzalez
R
R
Barmada
D
D
Fabiano
W
W
Meltzer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000145:classification* / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome