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Intraoperative fractures during uncemented Furlong bipolar hemiarthroplasty

  • Prakash ChandranEmail author
  • Ravindra P. Kamath
  • G. V. Johnson
Original Article

Abstract

Uncemented bipolar hemi-arthroplasty is one of the methods used to treat elderly patients with displaced intracapsular fractures of the femoral neck. In an effort to achieve a tight fit during uncemented hip hemiarthroplasty there are instances where intraoperative fractures have occurred. We retrospectively reviewed 165 consecutive uncemented Furlong Hydroxyapatite ceramic coated bipolar hemiarthroplasty performed for displaced intracapsular fracture neck of femur, and found 7.4% (12) intraoperative fractures of the proximal femur. Nine fractures involved the calcar, one each occurred in the anterior wall, posterior wall and greater trochanter. All fractures were linear and minimally displaced. Of the five fractures that occurred during reaming two were fixed with circlage wires. The remaining seven fractures occurred during prosthesis implantation of which three were fixed with circlage wires or cables. All patients had standard postoperative management and were allowed full weight bearing except in two patients (both fixed fractures) who were kept partial weight bearing for 6 weeks post operation. At 1 year follow up, all patients were mobilising full weight bearing and were pain free. We conclude, fractures of the proximal femur that occur while performing uncemented (Furlong) hemi-arthroplasty for the fractures of the femoral neck may not require any further intervention if the fracture involves the medial column, and is minimally displaced with a stable implant, regardless of whether they occur during reaming or implantation.

Keywords

Intraoperative fractures Uncemented hemiarthroplasty Hip 

Fractures peropératoires sur prothèse intermédiaire non cimentée de hanche

Résumé

L’arthroplastie non cimentée à cupules mobiles est l’une des techniques utilisées pour traiter les fractures du col du fémur intracapsulaires déplacées de la personne âgée. Dans un effort de réaliser un ajustement à frottement dur d’une prothèse non cimentée, des fractures peropératoires peuvent se produire. Nous avons contrôlé rétrospectivement 165 prothèses à cupules mobiles de FURLONG non cimentées et recouvertes d’hydroxyapatite, opérées consécutivement pour fracture intracapsulaires du col du fémur. Nous avons trouvé 7.4 %¨(12) fractures peropératoires de l’extrémité proximale du fémur. Neuf fractures passaient par le calcar, une dans les corticales antérieure, postérieure et le grand trochanter. Toutes ces fractures étaient linéaires et peu déplacées. Sur les cinq fractures survenues pendant l’alésage, deux furent fixées par cerclage. Les sept autres s’étaient manifestées pendant l’introduction de la prothèse et trois furent également fixés par cerclage ou câblage. Tous les patients eurent des soins postopératoires standard avec autorisation de mise en charge complète, sauf deux patients qui n’eurent droit qu’à un appui partiel pendant six semaines. Au contrôle à un an, tous les patients appuyaient complètement et sans douleur. Nous concluons que les fractures du fémur proximal survenant pendant la pose d’une prothèse intermédiaire de FURLONG pour fracture du col du fémur, ne nécessitent pas de réintervention si la fracture concerne la corticale médiale, si elle est peu déplacée, si l’implant est bien stable et qu’elles surviennent soit pendant l’alésage, soit pendant l’introduction de la prothèse dans le fût fémoral.

Mots clés

Fractures peropératoires Arthroplastie de hanche non cimentée Prothèse intermédiaire 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Prakash Chandran
    • 1
    • 4
    Email author
  • Ravindra P. Kamath
    • 2
  • G. V. Johnson
    • 3
  1. 1.Department of Trauma and OrthopaedicsWarrington HospitalWarringtonUK
  2. 2.Department of OrthopaedicsHull Royal InfirmaryHullUK
  3. 3.Hull Royal InfirmaryHull, West YorkshireUK
  4. 4.North CheshireUK

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