title: Periprosthetic femoral fractures after hemiarthroplasty. An analysis of 17 cases.
abstract: OBJECTIVE
  To describe the characteristics of patients with periprosthetic femoral fractures after hemiarthroplasty and analyze their treatment.
  
  
  METHODS
  An observational, longitudinal, retrospective study was conducted on a series of 17 patients with periprosthetic femoral fractures after hip hemiarthroplasty. Fourteen fractures were treated surgically. The characteristics of patients, fractures and treatment outcomes in terms of complications, mortality and functionality were analyzed.
  
  
  RESULTS
  The large majority (82%) of patients were women, the mean age was 86 years and with an ASA index of 3 or 4 in 15 patients. Ten fractures were type B. There were 8 general complications, one deep infection, one mobilization of a non-exchanged hemiarthroplasty, and 2 non-unions. There were 85% consolidated fractures, and only 5 patients recovered the same function prior to the injury. At the time of the study 9 patients had died (53%).
  
  
  CONCLUSIONS
  Periprosthetic femoral fractures after hemiarthroplasty will increase in the coming years and their treatment is difficult.
  
  
  CONCLUSIONS
  Periprosthetic femoral fractures after hemiarthroplasty are more common in women around 90 years-old, and usually occur in patients with significant morbidity. Although the Vancouver classification is reliable, simple and reproducible, it is only a guide to decide on the best treatment in a patient often fragile. The preoperative planning is essential when deciding a surgical treatment.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España. Electronic address: msuarez83@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Suárez-Huerta
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: A
authors.initials: A
authors.lastname: Roces-Fernández
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: R
authors.initials: R
authors.lastname: Mencía-Barrio
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Alonso-Barrio
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), León, España.
authors.forename: L R
authors.initials: LR
authors.lastname: Ramos-Pascua
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D062785:Hemiarthroplasty; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Clasificación de Vancouver; Femur; Fractura periprotésica; Fémur; Hemiarthroplasty; Hemiartroplastia; Periprosthetic fracture; Stem; Vancouver classification; Vástago