Predisposing factors for intraoperative femur fracture in primary total hip arthroplasty

Main Article Content

Damián Arroquy
Germán Garabano
Hernán Del Sel
Gustavo Gómez Rodríguez
Fernando Lopreite

Abstract

Background: the objective of this study was to characterize the predisposing factors for intraoperative femur fracture during primary total hip arthroplasty.Methods: from 1999 to 2010, 28 fractures occurring during 1943 primary total hip arthroplasties were analyzed, an incidence of 1.4%. Vancouver classification was used. The presence of predisposing factors, their treatment and clinical and radiological outcomes were evaluated.Results: twenty three (82.1%) fractures were type A and 5 (17.9%) were type B. The average of the cervical-shaft angle was 140° (120°-160°). 71.4% were women and 7.1% had previous osteosynthesis. The incidence was 3.54% (16/452) in cementless femoral stems and 0.8% in cemented femoral stems (12/1491). Intraoperative treatments were: cerclage wire in 18 cases (64.3%), metal mesh plus cerclage wire in one patient (3.6%) and conservative treatment in 9 patients. Twenty seven (96.4%) patients obtained good results and the average Harris Hip Score was 93 points (89-95).Conclusions: female patients, high cervical-shaft angle, hip dysplasia, cementless femoral stems and femur weakness after removing the osteosynthesis, are predisposing factors for this type of complication. For this reason, we suggest to perform a prophylactic cerclage wire when two o more of these predisposing factors are present.  

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Article Details

How to Cite
Arroquy, D., Garabano, G., Del Sel, H., Gómez Rodríguez, G., & Lopreite, F. (2014). Predisposing factors for intraoperative femur fracture in primary total hip arthroplasty. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 79(4), 237-242. https://doi.org/10.15417/330
Section
Clinical Research

References

1. Berry DJ. Epidemiology of periprosthetic fractures after major joint replacement: Hip and knee. Orthop Clin North Am
1999;30:183-90.

2. Duncan CP, Masri BA. Fractures of the femur after hip replacement. Inst Course Lect 1995;45:293-304.

3. Schwartz JT, Mayer JG, Engh CA. Femoral fracture during non-cemented total hip arthroplasty. J Bone Joint Surg Am
1989;71:1135-42.

4. Lopreite FA, Sandrigo S, del Sel H. Fractura intraoperatoria del acetábulo en la artroplastia total de cadera primaria. Rev Asoc
Argent Ortop Traumatol 2011;75:227-30.

5. Berend KR, Lombardi AV Jr, Mallory TH, Chonko DJ, Dodds KL, Adams JB. Cerclage wires or cables for the
management of intraoperative fracture associated with a cementless, tapered femoral prosthesis: results at 2 to 16 years.
J Arthroplasty 2004;19(7 Suppl 2):17-21.

6. Mitchell PA, Greidanus NV, Masri BA, Garbuz DS, Duncan CP. The prevention of periprosthetic fractures of the femur
during and after total hip arthroplasty. Instr Course Lect 2003;52:301-8.

7. Lopreite FA, Andres A, del Sel H. Orientación de los componentes en la artroplastia total de cadera. Comparación de resultados
radiográficos entre dos vías de abordaje. Rev Asoc Argent Ortop Traumatol 2003;68:111-7.

8. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a
method of classification. J Bone Joint Surg Am 1973;55:1629-32.

9. Franklin J, Malchau H. Risk factors for periprosthetic femoral fracture. Injury 2007;38:655-60.

10. Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury 2007;38:651.

11. Lindahl H, Garellick G, Regnér H, Herberts P, Malchau H. Three hundred and twenty-one periprosthetic femoral fractures.
J Bone Joint Surg Am 2006;88:1215-22.

12. Meek RM, Garbuz DS, Masri BA, Greidanus NV, Duncan CP. Intraoperative fracture of the femur in revision total hip
arthroplasty with a diaphyseal fitting stem. J Bone Joint Surg Am 2004;86:480-5.

13. Johansson JE, McBroom R, Barrington TW, Hunter GA. Fracture of the ipsilateral femur in patients with total hip
replacement. J Bone Joint Surg Am 1981;63:1435-42.

14. Mallory TH, Kraus TJ, Vaughn BK. Intraoperative femoral fractures associated with cementless total hip arthroplasty.
Orthopedics 1989;12:231-9.

15. Asayama I, Kinsey TL, Mahoney OM. Two-year experience using a limited incision direct lateral approach in total hip
arthroplasty. J Arthroplasty 2006;21:1083-91.

16. Sharkey PF, Hozack WJ, Booth RE Jr, Rothman RH. Intraoperative femoral fractures in cementless total hip arthroplasty.
Orthop Rev 1992;21:337-43.

Most read articles by the same author(s)

1 2 3 4 5 > >>