Intraoperative hip fractures: ruining your day.
The results of treatment of 116 intraoperative femoral fractures were reviewed. Excluding calcar and greater trochanter fractures, there were 14 Type I cases (Vancouver classification). All healed with cerclage wiring. Three cases of vertical fractures of the proximal segment following a subtrochanteric osteotomy did not heal and required revision. There were 8 Type II fractures, most being minor splits or limited, nondisplaced, vertical fractures. Control was lost in 2 wired cases, suggesting that Type II fractures should be converted to Type I by the use of a long stem, or, if impractical, by supplementary fixation. In 7 septic cases, a comminuted fracture occurred during implant removal. An intramedullary nail and cerclage wires were used, and the patients were left with a Girdlestone. The infections were overcome, the fractures healed, and subsequent revision was straightforward, because an open channel existed in the femur.
Cameron
Hugh U
HU
Orthopaedic & Arthritic Institute, Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada.
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001858:Bone Nails; D001864:Bone Wires; D020878:Device Removal / Q000009:adverse effects; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000209:etiology* / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D010027:Osteotomy / Q000009:adverse effects*; D016896:Treatment Outcome