title: Risk factors for intraoperative periprosthetic femoral fractures during the total hip arthroplasty.
abstract: BACKGROUND
  Intraoperative periprosthetic femoral fracture (IPFF) is one of the most frequent complication of total hip arthroplasty (THA). This complication is a very important factor affecting rehabilitation, hospitalization time and cost of treatment. It may occur during the intramedullary reaming, removal or fixation of the stem The aim of the study was to identify risk factors of IPFF, in order to devise strategies that would minimize incidence of this complication in the future.
  
  
  METHODS
  The study group consisted of patients who underwent hip surgery at the Department of Orthopaedics and Traumatology, Medical University of Silesia in Katowice between January 2002 and December 2006. We included cases of primary total hip replacement (both cemented and uncemented), hemiarthroplasties, revision THAs with exchange of at least one of the elements and the Girdlestone procedures.
  
  
  RESULTS
  The IPFF was diagnosed in 105 cases (101 patients), out of 1188 surgeries. We found the following risk factors for the primary THA: female gender, younger age, uncemented implant, the use of straight or revision stem, secondary osteoarthritis. For revision surgery there were: left hip surgery and implantation of revision stem.
  
  
  CONCLUSIONS
  We hope that identification of risk factors for the intraoperative periprosthetic femoral fracture would allow orthopaedic surgeons to select the group of patients with high risk of fracture and to devise strategies that would minimize incidence of this complication in the future.
authors.affiliation: Department of Orthopaedics and Traumatology, Medical University of Silesia in Katowice, Katowice, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Nowak
authors.forename: Damian
authors.initials: D
authors.lastname: Kusz
authors.forename: Piotr
authors.initials: P
authors.lastname: Wojciechowski
authors.forename: Robert
authors.initials: R
authors.lastname: Wilk
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology* / Q000601:surgery; D011044:Poland; D011475:Prosthesis Failure / Q000009:adverse effects*; D012307:Risk Factors; D016896:Treatment Outcome