Aggressive Surgical Treatment of Periprosthetic Femur Fractures Can Reduce Mortality: Comparison of Open Reduction and Internal Fixation versus a Modular Prosthesis Nail

Langenhan, Ronny; Trobisch, Per; Ricart, Pedro A.; Probst, Axel

doi:10.1097/bot.0b013e31821d6f55

Cited by 33 publications

(13 citation statements)

References 27 publications

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“…These authors observed a higher 1-year mortality rate in patients treated with internal fixation (33%) than those treated with revision arthroplasty (12%) in type B fractures. Moreover, immediate postoperative full weight bearing has been related to lower total and 6-month mortality in a recent article [28]. Another study confirmed that a delay to surgery of greater than 2 days from admission increased the 1-year mortality rate [26].…”

Section: Discussionmentioning

confidence: 87%

Functional and radiological outcome of periprosthetic femoral fractures after hip arthroplasty

Moreta

Aguirre

Ugarte

et al. 2015

Injury

100

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Section: Discussionmentioning

confidence: 87%

Functional and radiological outcome of periprosthetic femoral fractures after hip arthroplasty

Moreta

Aguirre

Ugarte

et al. 2015

Injury

100

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“…[4][5][6] The earlier weight bearing and improved mobilization associated with revision arthroplasty with implants that span the fracture may provide for improved mortality rates if patients who can withstand the magnitude of such surgery are properly selected. However, revision of an associated well-fixed stem to a long-stem modular prosthesis nail that spans the fracture has recently been advocated by several authors for Vancouver B fractures regardless of the stem stability.…”

Section: Revision Hip Arthroplastymentioning

confidence: 99%

“…49 Furthermore, this study demonstrated an 8-fold higher mortality rate (7.3%) seen in the patients with periprosthetic fracture. Langenhan et al, 5 because of high mortality rates after ORIF, altered their treatment protocol in 2001 and began performing stem replacement with a distally locked modular prosthesis nail for the majority of periprosthetic femur fractures, Vancouver B and C, regardless of the stem stability. Langenhan et al, 5 because of high mortality rates after ORIF, altered their treatment protocol in 2001 and began performing stem replacement with a distally locked modular prosthesis nail for the majority of periprosthetic femur fractures, Vancouver B and C, regardless of the stem stability.…”

Section: Revision Hip Arthroplastymentioning

confidence: 99%

Periprosthetic Femur Fractures

Ricci

2015

Journal of Orthopaedic Trauma

115

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Successful treatment of periprosthetic femur fractures, like all fractures, requires careful attention to understand the fracture pattern nuances, identifying and executing a rational treatment approach, and providing an appropriate postoperative recovery protocol. Unlike most other fractures, modification of standard techniques is often required to obtain a stable fixation construct, and there is a greater role for revision arthroplasty in the treatment of periprosthetic fractures. Optimal indications for surgical repair versus revision arthroplasty and optimal postoperative weight-bearing protocols remain uncertain. Reported outcomes for patients with periprosthetic femoral shaft fractures are generally good and are relatively consistent. Results for periprosthetic distal femur fractures, however, are less good and more inconsistent. Both periprosthetic femoral shaft and distal femur fractures are associated with relatively high mortality rates, approaching that of patients with hip fractures. This review should provide insight into the current solutions and challenges for the treatment of patients with periprosthetic femur fractures.

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“…The postoperative period is also challenging for patients, given the burden of medical co-morbidities in this population, as well as the frequent need for extended periods of protected weightbearing [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Management of periprosthetic femoral fractures following total hip arthroplasty: a review

Abdel

Cottino

Mabry

2015

International Orthopaedics (SICOT)

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Periprosthetic femoral fractures after primary total hip arthroplasty are a complex and clinically challenging issue. The treatment must be based on the fracture, the prosthesis, and the patient (Table 1). The Vancouver classification is not only helpful in classifying the fractures, but also in guiding the treatment. In general, well-fixed stems require open reduction and internal fixation, whereas loose stems require revision arthroplasty.

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Aggressive Surgical Treatment of Periprosthetic Femur Fractures Can Reduce Mortality: Comparison of Open Reduction and Internal Fixation versus a Modular Prosthesis Nail

Abstract: Treatment of periprosthetic femur fractures with femoral component exchange to a modular prosthetic nail that allows immediate postoperative full weightbearing may decrease mortality.

Cited by 33 publications

References 27 publications

Functional and radiological outcome of periprosthetic femoral fractures after hip arthroplasty

Functional and radiological outcome of periprosthetic femoral fractures after hip arthroplasty

Periprosthetic Femur Fractures

Management of periprosthetic femoral fractures following total hip arthroplasty: a review

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