title: Operative treatment of early peri-prosthetic femur fractures following primary total hip arthroplasty.
abstract: The risk factors for and results of operatively treated peri-prosthetic femoral fractures sustained within 90 days following primary THA were evaluated. 5,313 consecutive THAs were reviewed and 32 (0.60%) fractures were identified which included 9 A(g), 2 B(1), 18 B(2), 1 B(3), and 2 A(g)/B(2) fractures. 19 (61%) patients sustained 23 complications including 9 greater trochanter non-unions, 2 femoral shaft non-unions, 3 patients with Brooker III HO, and 2 deep infections. 7 patients (23%) required a second operative procedure and one patient required a third. Peri-prosthetic fractures were associated with advancing age, female gender, developmental hip dysplasia, and cementless metaphyseal engaging components, particularly flat wedge tapers. Overall, operative treatment of acute peri-prosthetic fractures is associated with a high rate of complications (61%) and re-operation (23%).
authors.affiliation: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: Neil P
authors.initials: NP
authors.lastname: Sheth
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Brown
authors.forename: Mario
authors.initials: M
authors.lastname: Moric
authors.forename: Richard A
authors.initials: RA
authors.lastname: Berger
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D015995:Prevalence; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult