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Treatment Algorithm of Periprosthetic Femoral Fracturens.

Treatment Algorithm of Periprosthetic Femoral Fracturens.

Authors :
Mondanelli, Nicola
Troiano, Elisa
Facchini, Andrea
Ghezzi, Roberta
Di Meglio, Martina
Nuvoli, Nicolò
Peri, Giacomo
Aiuto, Pietro
Colasanti, Giovanni Battista
Giannotti, Stefano
Source :
Geriatric Orthopaedic Surgery & Rehabilitation; 5/10/2022, Vol. 13, p1-16, 16p
Publication Year :
2022

Abstract

Introduction. The ever-expanding indications for total hip arthroplasty are leading to more implants being placed in younger as well as in older patients with high functional demand. Also, prolonged life expectancy is contributing to an overall increment of periprosthetic femoral fractures. The Vancouver classification has been the most used for guiding the surgeon choice since its proposal in 1995. Fractures occurring over a hip femoral implant can be divided into intra-operative and post-operative PFFs, and their treatment depends on factors that may severely affect the outcome: level of fracture, implant stability, quality of bone stock, patients' functional demand, age and comorbidities, and surgeon expertise. There are many different treatment techniques available which include osteosynthesis and revision surgery or a combination of both. The goals of surgical treatment are patients' early mobilization, restoration of anatomical alignment and length with a stable prosthesis and maintenance of bone stock. Significance. The aim of this review is to describe the state-of-the-art treatment and outcomes in the management of PFFs. We performed a systematic literature review of studies reporting on the management of PFFs around hip stems and inter-prosthetic fractures identifying 45 manuscripts eligible for the analysis. Conclusions. PFFs present peculiar characteristic that must be considered and special features that must be addressed. Their management is complex due to the extreme variability of stem designs, the possibility of having cemented or uncemented stems, the difficulty in identifying the "real" level of the fracture and the actual stability of the stem. As a result, the definition of a standardized treatment is unlikely, thereby high expertise is fundamental for the surgical management of PPFs, so this kind of fractures should be treated only in specialized centres with both high volume of revision joint arthroplasty and trauma surgery. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
21514585
Volume :
13
Database :
Complementary Index
Journal :
Geriatric Orthopaedic Surgery & Rehabilitation
Publication Type :
Academic Journal
Accession number :
156805156
Full Text :
https://doi.org/10.1177/21514593221097608