O2272 AN ANALYSIS OF 63 OPERATIVELY TREATED PERIPROSTHETIC FRACTURES OF THE FEMUR

Introduction: Femoral fracture after total or hemiar-throplasty is an uncommon but often difþcult complication to treat. Its incidence varies from 1% after primary THA to 4% after revision THA. The goal of our study was to determine the healing rate of the fractures and the clinical outcome of the patients analysed against type of fractures, method of þxation and loosening of the prostheses. Methods: We retrospectively analysed 63 operatively treated patients with periprosthetic femoral fractures operated on in two large institutions from the year 1994 with at least 12 month of follow-up. Fractures were classiþed according the Vancouver classiþcation system. Perioperative femoral fractures were excluded from the study. Results: According the Beals and Tower we had 38 excellent, 13 good and 7 poor results, one patient died in the early postoperative period and 4 were lost to follow-up. 16 procedures were associated with a perioperative complication. Conclusions: We think that fractures associated with a loose interface cemented or cementless are best treated by removal of the implant and insertion of a long stemmed prosthesis in the reduced femur. A periprosthetic fracture associated with a stable prosthesis can be safely treated by a reduction and internal þxation. The use of cement in revision is a good choise in the older patient who needs a fast mobilisation and early full weight bearing.