Hip Arthroplasty Complications
An 82-year-old woman with a 10-year-old cemented THA falls at home and presents with thigh pain and inability to bear weight. X-rays show a spiral fracture of the femur extending from 5cm below the tip of the femoral stem to 15cm distally. The fracture is displaced with medial comminution. The stem appears well-fixed with no lucency or subsidence. AP pelvis shows symmetric femoral components with no acetabular loosening. The orthopaedic surgeon discusses the Vancouver classification, assessment of stem stability, and whether ORIF or revision is indicated. Regarding periprosthetic femoral fractures around THA:
Mark each as TRUE or FALSE
Periprosthetic femoral fractures occur in 1-4% of primary THA and up to 20% of revision THA; risk fa...
VANCOUVER CLASSIFICATION based on fracture LOCATION and stem STABILITY: Type A (trochanteric - AG gr...
Periprosthetic fractures occur in 30-40% of THA; they result from high-energy trauma only; osteoporo...
Treatment: Type AG (greater trochanter) = nonoperative vs ORIF with cables/wires; Type B1 (STABLE st...
ORIF principles: LOCKING plates preferred (minimize periosteal stripping); CABLE/WIRE augmentation f...
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Click T (True) or F (False) for each option