title: Causes of failure in periprosthetic fractures of the hip at 1- to 14-year follow-up.
abstract: BACKGROUND
  The results and causes of failure for 61 patients undergoing surgery for femoral hip periprosthetic fracture are reported.
  
  
  METHODS
  Fractures were classified according to the Vancouver System. Osteosynthesis was performed in 88% of cases and prosthetic revision in 12% of cases. Clinical and functional outcomes were assessed according to the Harris Hip Score and radiological results were evaluated using Beals and Tower's criteria.
  
  
  RESULTS
  At a mean follow-up of 32 months, the Harris Hip Score was 73.1 and the radiological results were excellent-to-good in 72.2% of patients after the first surgery. At the end of treatment, complete healing of the fracture and stability of the prosthesis was found in 87.3% of patients. The most relevant result was the recovery of walking in 73.8% of patients. Mortality after surgery was 1.6% at 3 months and 3.3% at 12 months. A higher mortality rate occurred when surgery was delayed more than 5 days after trauma.
  
  
  CONCLUSIONS
  The analysis of our cases shows that in Vancouver type B1 fractures treated with plating osteosynthesis, there were worse outcomes in total hip arthroplasty with cemented stems compared with uncemented stems. In Vancouver type B2 fractures with cementless straight stems, osteosynthesis with a plate can be a valid option. In Vancouver type C fractures, the stability of the stem must be carefully assessed.
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. Electronic address: spina.mauro@gmail.com.
authors.forename: Mauro
authors.initials: M
authors.lastname: Spina
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Rocca
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Canella
authors.affiliation: Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Scalvi
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D011859:Radiography; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013997:Time Factors; D017211:Treatment Failure
keywords: Arthroplasty revision; Fracture fixation; Hip prosthesis; Periprosthetic fracture; Vancouver classification