Periprothetische Femurfrakturen nach Hüftgelenksersatz: Rationale für die intra- oder extramedulläre Behandlung

C. Haag, M. Seif El Nasr, H. Schmal, H.P. Friedl

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

In our institution from 1991 to 1998 48 patients (32 women and 16 men) were treated for periprosthetic fractures of the femur following total hip arthroplasty (THA). A fracture of the femur was found in 47 cases, and once the acetabulum was fractured. The average age was 80.2 years, and the average time the prosthesis had been in place 11.4 years. Evidence of loosening of the prosthesis was present in 22 patients (46.8%). The proportion of cemented to non-cemented prostheses was 7:1 (42:6). 11 patients already underwent 1 and 1 patient 3 exchanges of the prosthesis because of repeated periprosthetic fractures. The periacetabular fracture was treated by replacement of the socket. The periprosthetic femoral fractures were classified after Whittaker [19]. 2 of 47 patients were not able to tolerate an anesthesia because of cardiac and pulmonary malfunctions. Of the remaining 45, 2 patients were stabilized by tension wires, 29 by extramedullary plate osteosynthesis (19 LCDCP, 10 condylar plates) and 20 with a cancellous bone graft. In 14 cases the prosthesis was replaced. The total complication rate was expected fairly high (12 cases, 26.6%), considering age and general health of our investigated population of patients. Only 2 patients could be sent home after operation, following a 14-day hospital stay. The analysis of this population of patients shows that a preexisting stress such as osteoporosis, a previous successful prosthesis replacement and loosening of the prosthesis increases the likelihood of an occurring periprosthetic fracture. The region around the tip of the prosthesis is particularly endangered to undergo a fracture in case of an impact. After the replacement of a prosthesis, older patients benefit from early mobility and exercise.
Bidragets oversatte titelPeriprosthetic fractures of the femur after total hip arthroplasty: Rationale of intra- and extramedullary treatment
OriginalsprogTysk
TidsskriftAktuelle Traumatologie
Vol/bind30
Udgave nummer2
Sider (fra-til)48-55
Antal sider8
ISSN0044-6173
StatusUdgivet - 29. apr. 2000

Emneord

  • acetabulum
  • article
  • bone graft
  • clinical article
  • exercise
  • femur fracture
  • heart function
  • hip arthroplasty
  • human
  • intramedullary nailing
  • lung function
  • osteosynthesis
  • patient care
  • prosthesis loosening
  • treatment planning

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