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E-BABE-Periprosthetic Fractures Following Hemi-Arthroplasty of Hip
Lokesh Kumar Yogi
Background: Hemi-arthroplasty of hip for intracapsular
fractures of femoral neck is one of the most commonly
done surgical procedures in the low mobility older Indian
population. Although there are numerous complications
associated with the procedure, we want to study the types
and management of peri-prosthetic fractures in patients
treated with hip hemi-arthroplasty.
Methods: A total of 26 patients were included in the
study. A retrospective analysis of the radiological cum
clinical diagnosis and management of peri-prosthetic
fractures was performed. All patients were followed up
till 1.5 years post-operatively.
Results: According to Vancouver classification of
peri-prosthetic fractures, 10 fractures were classified as
type A, 7 as type B1, 3 as type B2, 4 as type B3 and 2 as
type C. Fractures were managed either by Open Reduction
with Internal Fixation (ORIF) or Revision hemi-arthroplasty.
Fractures type AG, B1 and C were managed
with ORIF and type B2 and B3 fractures were managed
with revision hemi-arthroplasty using longer stem.
Conclusions: As evident in our study, majority of fractures
occurred intra-operatively, a thorough evaluation of
pre-operative x-rays of both hips should be done along
with special focus on anatomical variations. Correct diagnosis
based on radiological and intraoperative findings
followed by appropriate treatment are of paramount importance
in the management of peri- prosthetic fractures.