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KMID : 0386720020140010056
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Journal of the Korean Hip Society
2002 Volume.14 No. 1 p.56 ~ p.65
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Periprosthetic Fractures of the Femur after Total Hip Arthroplasty
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Hwang Deuk-Soo
Lee Kwang-Jin
Kwak Sang-Koo
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Abstract
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Purpose : To analyze the clinical and radiologic results according to the type of fracture and treatment method by classifying the fracture types in patients with ipsilateral femoral periprosthetic fractures that occurred after total hip arthroplasty.
Materials and methods : Among the patients who received total hip arthroplasty during the period from February 1997 to March 2000, 18 cases in 17 patients who had ipsilateral femoral fractures were selected. The mean follow-up period was 27 months. Johansson’s classification, along with the presence or absence of femoral stem loosening, was used to classify the fractures. Evaluation of the results was based on the bony union and the Harris hip score.
Results : The numbers of patients according to type were 6 cases for Johansson Ⅰ with stem loosening, and 2 more without loosening; 3 cases for Johansson Ⅱ with loosening, and 4 more without loosening: and 3 cases for Johansson Ⅲ, all without loosening. The average time for bony union was 4.9 months. The function of the hip joint after operation was 92 points on the Harris Hip score, which was satisfactory. As for complications, there were 2 cases of nonunion, one of deep infection, 2 of leg length discrepancy, one of femoral stem loosening, and one of metal breakage.
Conclusion : In treating perioprosthetic femur fracture after total hip arthroplasty, if the fracture is stable then the selection of treatment method should be cautiously made according to the type of stem, usage of bone cement, and the fracture. It’s also suggested that stem loosening should be rigorously checked for intra-operatively, even in the absence of any evidence on pre-operative radiologic studies.
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KEYWORD
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Periprosthetic fracture, Total hip arthroplasty
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