Fixation of a complex comminuted proximal femoral fracture in the presence of a Birmingham hip resurfacing prosthesis

Intramedullary fixation of pertrochanteric fractures after hip resurfacing arthroplasty – Do we have the answer? Case report and literature review

“…However, we did not face any difficulty during insertion of the intramedullary nail nor did the surgical technique cause any further comminution at the fracture site. Annig et al 11 reported good results following intramedullary fixation with circumferential wiring in their case report of a patient with a multi fragmentary fracture of the proximal femur around a hip resurfacing implant. They used a piriform fossa entry reconstruction nail with two proximal screws.…”

Intertrochanteric fracture below Birmingham Hip Resurfacing: Successful non-operative management in two cases

“…1 There have been no previous published reports of nonoperative treatment of intertrochanteric fracture. Our two cases illustrate that patients who sustain minimally displaced intertrochanteric peri-prosthetic fractures with a well-fixed Birmingham hip resurfacing may be successfully managed non-operatively.…”

Peri-prosthetic fracture neck of femur following metal-on-metal Birmingham hip resurfacing treated by internal fixation

“…5,6 Aning et al described a complex comminuted proximal fracture treated with a cephalomedullary reconstruction nail and two proximal interlocking screws on either side of the resurfacing femoral stem. 2 Weinrauch and Krikler reported an intertrochanteric femoral fracture distal to the hip resurfacing implant treated successfully with an angled blade-plate. 12 Revision to a stemmed modular component is more frequently performed for a displaced sub-capital/trans-cervical peri-prosthetic fracture neck of femur following metal-on-metal resurfacing.…”

“…3 Various reports of non-operative treatment 5,6 and revision surgery 1,10 have been published. Aning et al 2 and Weinrauch and Krikler 12 reported successful internal fixation of peri-prosthetic proximal femoral fractures (extracapsular) following hip resurfacing with cephalomedullary nail and angled blade-plate, respectively. We describe to our knowledge, the first case of successful internal fixation for a peri-prosthetic intracapsular (basi-cervical) fracture neck of femur after Birmingham metal-on-metal hip resurfacing.…”