Abstract

CABRAL, Rui. Fraturas periprotésicas em artroplastias da anca: Estratégias cirúrgicas. Rev. Port. Ortop. Traum. [online]. 2012, vol.20, n.1, pp.73-80. ISSN 1646-2122.

The periprosthetic fratures in hip arthroplasties are a type of complication that can require a difficult surgical solution. The aim of this study was to evaluate the efficacy of some surgical strategies in the different frature types. The periprosthetic hip fratures were classified according a modified Vancouver classification. We treated 112 patients (67 men and 45 women), 105 femoral fratures (94%) and 7 acetabular fratures (6%). The mean follow-up was 10.6 years. In the fratures of type A (7 cases-7%), B1 (10 cases-10%) or C (13 cases-12%) fratures around well fixed femoral stems we only fixed the fratures. In the fratures of type B2 (17 cases-16%), B3 (46 cases-44%) and D (12 cases-11%, clinical cases with more than one frature, not contemplated in the Vancouver classification) we used an uncemented long femoral stems, fixation with metallic cables and cancellous bone allografts to fill the femoral bone loss. We observed, as complications, 3 deep infection (2,7%), 3 early hip dislocations treated by closed reductions, 2 cases with asymptomatic trochanteric non-union and 1 femoral refracture. We needed to reoperate 4 patients (3,6%): 3 infection cases (2 cases with two-stage revision and 1 case we removed all the prosthesis components) and 1 case of femur refrature (new osteosynthesis of the femoral frature). In the periprosthetic hip fratures treatment is very important to have a philosophy and surgical strategy, with an availability of more adequate surgical material to the resolution of which clinical case.

Keywords : Periprosthetic fratures; revision hip arthroplasty.

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