The contribution of cortical strut allograft to periprosthetic femur fractures

Objective To study the treatment of intraoperative periprosthetic femur fractures in revision THR.Methods Retrospective study was made on 32 patients who did not have infection and had periprosthetic fractures of the femur during revision THR from October 2002 to February 2007.Fractures were classified using the Vancouver classification system.There were 11 cases of type A,16 cases of type B,2 cases of type C,3 cases had both type A and type B fractures.There were 24 cases using extensively porous-coated stem supplemented by cortical strut,6 cases using extensively porous-coated stem and wires,1 case using cement stem,and 1 case fixed by cortical strut.Results Twenty-eight cases were followed up with the mean period of 23.5 months (range,3～56 months).All patients had unions of the fractures between 12 to 22 weeks after surgery (average 17.5 weeks).In one patient,the struts were fractured at 17th week.One patient experienced pain in the affected limb and two stiffness of the ipsilateral knee.The postoperation mean Harris score was 92.Conclusion The treatment of intraoperative periprosthetic fracture around the femoral implant can successfully restored function for most patients.An uncemented,extensively porous-coated stem may be a good choice.Cortical strut allograft is a useful technique for the management of periprosthetic fractures with poor host hone stock.