Clinical Report Of 19 Cases For Periprosthetic Femoral Fractures

[Objective] To analyse risk factors, treatment results and prognosis of periprosthetic femoral fractures after total hip arthroplasty.[Methods] A retrospective follow—up study of 19 cases from Novembr 2001 to April 2009. Seven were male and 12 were female,and the mean age was 55years (range,44 to 86 years). According to Vancouver Classification, there were 6 type B1 fractures,12 type B2 fractures,1 type B3 fracture. One was treated by conservative method,13 were treated by revision, and 5 were treated operated with open reduction and internal fixation.[Result] The mean follow—up period was 31 mortths(range,6 to 69 months). One with Conservative treatment gained fracture unite after 6 moths with a 86 Harris score. Thirteen with revision gained fractures unite at a mean of 4.1 months (range,3 to 7 months) with a mean of 79 Harris score (range,60 to 93). Five with open reduction and internal fixation gained fractures unite at a mean of 6.6 months (range, 3 to 10 months) with a mean of 75 Harris score (range,67 to 86)[Conclusion] The main causes of periprosthetic femoral fractures after total hip arthroplasty are osteoporosis, osteolysis and local stress focus. Open reduction and internal fixation is appropriate for Vancouver type B1, while revision with long stem is appropriate for Vancouver type B2 and type B3, which could be assisted by cortical allograft plates.