Breaking Bad: A Comparative Descriptive Analysis of Periprosthetic Fractures Around Cemented and Uncemented Femoral Stems

Periprosthetic fractures are most commonly classified according to the Vancouver classification system and more recently the Unified Classification System. The aim of this study is to provide a descriptive analysis of fracture patterns in femoral periprosthetic fractures (PPFs) by femoral stem fixat...

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Bibliographic Details
Published in:The Journal of arthroplasty 2019-08, Vol.34 (8), p.1783-1786
Main Authors: Fenelon, Christopher, Murphy, Evelyn P., Baig, Muhammad N., Kearns, Stephen R., Murphy, Colin G., Curtin, William
Format: Article
Language:English
Subjects:
cemented
fracture
pattern
periprosthetic
uncemented
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Summary:Periprosthetic fractures are most commonly classified according to the Vancouver classification system and more recently the Unified Classification System. The aim of this study is to provide a descriptive analysis of fracture patterns in femoral periprosthetic fractures (PPFs) by femoral stem fixation. A retrospective observational study of all femoral PPFs over a 10-year period at our institution was conducted. Presenting radiographs were examined to assess the fracture pattern. Over the 10-year period, 138 femoral PPFs that underwent operative treatment were examined. Mean age of patients was 78 years with 45.7% male and median American Society of Anaesthesiologists grade 3. The femoral stem fixation was cemented in 83 patients and uncemented in 55 patients. Uncemented femoral stems most commonly caused a simple oblique fracture pattern (69.1%) with a more comminuted pattern seen in cemented fixation (59%). Fracture patterns differ according to femoral stem fixation. A simple “sickle-like” oblique fracture pattern was more commonly seen in uncemented stems while cemented tapered stems resulted in a comminuted “axe splitting” pattern.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2019.03.051