title: A prospective, modernized treatment protocol for periprosthetic femur fractures.
abstract: This article reports a prospective series of periprosthetic femur fractures in 33 patients treated with a modernized fracture treatment protocol. Some form of operative treatment was selected prospectively based on the categorization of the fracture by the Duncan-Vancouver and Beals-Tower Oregon classification systems. Fractures in which the prosthesis-bone interface was stable were treated with open reduction and internal fixation of the fracture around the stable implant. Unstable prosthesis-bone interfaces required removal of the primary prosthesis and revision to an uncemented long-stem prosthesis after stabilization of the femoral fracture with plates or allograft struts. Complications were minimal over an average follow-up period of 28.3 months; restoration of function was predictable.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health Sciences Center, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. pduwelius@aol.com
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Duwelius
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Schmidt
authors.forename: Richard F
authors.initials: RF
authors.lastname: Kyle
authors.forename: Vanessa
authors.initials: V
authors.lastname: Talbott
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ellis
authors.forename: Jay B V
authors.initials: JB
authors.lastname: Butler
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome