Plamen Ivanov (Sofia / BG), Nikola Hariskov (Sofia / BG), Vladimir Stefanov (Sofia / BG), Borislav Zlatev (Sofia / BG), Nedelcho Tsachev (Sofia / BG)
Abstract text (incl. references and figure legends)
Introduction.
With the increase in total hip arthroplasty and the aging of the population, complications, in particular, periprosthetic fractures, increase. These are complicated fractures that require an individual approach due to the presence of an implant and the assessment of its stability. The main goal of the treatment is to get optimal reduction of the fracture and to have functional joint without pain. The purpose of the presentation is to identify the different types of periprosthetic fractures and the individual approach to each of them.
Materials and methods.
We present 22 cases with 5 year follow up of periprosthetic fractures that belong to different groups of the Vancouver classification, during and after the hip replacement surgery. Various solutions are applied - plates, alloosteoplasty, stem revision, cerclage. 3 patients suffered from high energy trauma, and 19 – low energy trauma. In group with low energy trauma average age was 80, in other group- 55
Results.
In the follow up we have 2 refractures due to debricolage or non-union and they had to be reoperated. 4 Patient had died in process of following up due to other illness.
Conclusion.
Patients have good clinical and radiological results and minimal complications. In such a complicated cases we need to choose the best method to maintain stability and secure union. In older patient with low energy trauma we discovered loosened endoprothesis. Despite relaxation of the endoprotesis some of the patient was treated with plates and cerclage due to the high risk for the patient with revision THA.
Key words.
Preriprosthetic fracture, Vancouver classification, reoperation, stability, THA
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I do not have financial interest.