title: Management of periprosthetic femoral fractures.
abstract: We followed up 37 periprosthetic fractures to assess the factors related to the outcomes and the loosening of prostheses. The average union time is 3.1 months (range, 2-6.2 months). The most common types were fractures around the stem tip and displaced (89.1%). In our study, the loosening rate (32.4%) was low compared with other reports. These might be due to the cementless stem, but the difference was not significant (P>.05). After management of the fracture with a plate, we noted 5 complications: 2 nonunion and 3 refractures. The causes of these complications were related to screw in the level of the stem tip. Therefore, in the management of fractures with plates, we do not recommend using a screw in the area of the stem tip but rather using a cerclage proximally and bone graft. If stem was unstable or stability was uncertain, and the arthroplasty did not function well previously, revision with a distal fluted stem showed an early bony union.
authors.affiliation: Department of Orthopedics, Chonbuk University Hospital and the Institute of Medical Science, Keumam-dong, Chonju, South Korea.
authors.forename: Myung-Sik
authors.initials: MS
authors.lastname: Park
authors.forename: Yung-Keun
authors.initials: YK
authors.lastname: Lee
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Yang
authors.forename: Sung-Jin
authors.initials: SJ
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001860:Bone Plates; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016896:Treatment Outcome