Abstract
We describe a case of an intracapsular neck of femur fracture occurring below an arthrodesed hip. This is an unusual fracture. We propose a method of conversion of this fracture to a constrained cup arthroplasty based on our experience of failure of screw fixation. Hip arthrodesis remains an acceptable method of treatment in degenerative hip disease (Panagiotopoulos et al. in Instr Course Lect 50:297–305, 2001). It provides pain relief, enables an active lifestyle and reduces the need for multiple revision surgeries compared to total hip arthroplasty (Beaule et al. in J Am Acad Orthop Surg 10:249–258, 2002). Its prevalence in the management of TB coxarthritis before the advent of antituberculous treatment means a trauma surgeon should be aware of the possibility of this fracture in the ageing population.
Résumé
Les auteurs décrivent un cas de fracture intra-capsulaire du col du fémur survenue après une arthrodèse de hanche. Il s’agit d’une fracture inhabituelle. Ils proposent une méthode de conversion de cette fracture vers une arthroplastie à cupule contrainte basée sur leur expérience des échecs des vissages. L’arthrodèse de hanche reste une alternative acceptable du traitement de la coxarthrose dégénérative. Elle entraîne l’indolence, permet une vie de relation active et diminue la nécessité de réinterventions multiples, au contraire de l’arthroplastie totale. Sa prévalence dans le traitement de la coxalgie tuberculeuse avant l’apparition du traitement antibiotique spécifique, doit faire se souvenir le chirurgien traumatologue à retenir cette indication dans le traitement de certaines fractures du col du fémur chez les sujets âgés.
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Jones, L.D., Hampton, R. & Ansari, A. A treatment option for femoral neck fractures complicating hip arthrodesis: conversion to a constrained total hip replacement. Eur J Orthop Surg Traumatol 17, 203–205 (2007). https://doi.org/10.1007/s00590-006-0139-3
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DOI: https://doi.org/10.1007/s00590-006-0139-3