Proximal Femoral Nailing for Intertrochanteric Fracture in Birmingham Hip Resurfacing Arthroplasty

Setia, Piyush; Gaitonde, Atul

doi:10.17554/j.issn.2311-5106.2020.07.387

Cited by 1 publication

(1 citation statement)

References 10 publications

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“…According to the literature, the most commonly reported technique for fixation of an extracapsular fracture in the presence of a well-fixed RHA is the use of a contoured locking compression plate (LCP) [ 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].There have also been reported incidences of this type of periprosthetic fracture being treated non-operatively [ 8 , 9 , 31 ]. Other techniques are reported – particularly the use of an intramedullary nail, proximal femoral blade plate, and dynamic hip screw [ 16 , 20 , 24 , 28 , 30 , 32 , 33 ]. However, there are recognized downsides to these devices including concerns about the adequacy of screw purchase in the proximal femur around the RHA.…”

Section: Introductionmentioning

confidence: 99%

Fixation and Implant Retention of Extracapsular Femoral Neck Periprosthetic Fractures Around Hip Resurfacing Arthroplasty – A Case Series

Patel¹,

Ayub²,

Iranpour³

et al. 2021

JOCR

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Introduction: Background: Extracapsular femoral neck fractures in the presence of a resurfacing hip arthroplasty (RHA) appear to be independent of suboptimal technique during the initial implantation of the RHA and present with a similar etiology as native hip fractures – that is, a fragility fracture related to pathological or age-related osteoporosis, as a consequence of trauma. In the presence of a well-fixed and previously well-functioning RHA, the options for management include revision arthroplasty or open reduction and internal fixation (ORIF). In the absence of loosening through mechanisms of wear, infection, metallosis, or suboptimal prosthesis positioning, many authors have advocated ORIF with implant retention. However, there is often debate regarding the use of total hip arthroplasty in these cases Case Series: The authors conducted a thorough assessment of the literature followed by a retrospective review of outcomes for three patients treated by ORIF with implant retention for extracapsular femoral neck fractures around a RHA, using a standardized technique. All patients were independently mobile and active with well-fixed and well-functioning RHAs before the date of injury. All patients suffered low-energy trauma resulting in the fracture. There were no intraoperative or perioperative complications. All patients achieved full weight-bearing status and independent mobility. Two patients achieved radiographic union and returned to full range of movement and independent mobilization comparable to their preoperative state. One patient was lost to follow-up. Conclusion: The authors believe that fixation of extracapsular proximal femoral fractures distal to a well-fixed, well-functioning RHA is a good management option in an independent and active patient. A higher level of evidence is needed to investigate the surgical management options of these injuries comparing osteosynthesis with revision arthroplasty. Keywords: Periprosthetic fracture, hip resurfacin

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