title: Evaluation of treatment outcomes of periprosthetic femoral fractures after hip replacement surgery.
abstract: BACKGROUND
  The aim of this paper is to evaluate treatment outcomes of periprosthetic femoral fractures (PFFs) after total hip arthroplasty (THA).
  
  
  METHODS
  The study group consisted of 119 patients (125 procedures) with PFFs, including 101 patients (105 procedures) with intraoperative fractures and 20 with postoperative fractures. Intraoperative PFFs occurred in 84 primary arthroplasties and in 21 revision arthroplasties. The control group comprised 390 patients (408 procedures) without PFFs. The Harris Hip Score (HHS) questionnaire was used to evaluate the influence of the fracture and its type according to the Vancouver classification and the treatment method on the patients' clinical status.
  
  
  RESULTS
  No statistically significant differences were found between HHS scores of patients with intraoperative PFFs and patients without fractures or between the group of patients after revision THA performed due to a late PFF and patients reoperated on for other reasons. Trendelenburg's sign was positive more frequently in patients with an intraoperative PFF after revision THA than in those after primary THA (p=0.006). The small size of the subgroups studied did not make possible a reliable analysis of PFF treatment outcomes for given types of fractures according to the Vancouver classification and their respective treatment methods.
  
  
  CONCLUSIONS
  1. Treatment outcomes of intraoperative PFFs are satisfactory despite the use of simple fixation methods, as opposed to poor treatment outcomes of postoperative fractures, whose stabilization required the use of complicated surgical methods. 2. The results did not allow for determining the influence of the type of fracture according to the Vancouver classification and the treatment method on the clinical condition of patients after PFF treatment.
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine Medical University of Silesia in Katowice, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Nowak
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine Medical University of Silesia in Katowice, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Kusz
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine Medical University of Silesia in Katowice, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Kamiński
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology* / Q000601:surgery*; D011184:Postoperative Period; D012086:Reoperation; D016896:Treatment Outcome