[Mid-term effectiveness of cerclage wires fixation in treatment of periprosthetic femoral fractures associated with primary hip arthroplasty].

OBJECTIVE

To evaluate the mid-term effectiveness of cerclage wires fixation in treating Mallory typeⅡperiprosthetic femoral fractures associated with primary hip arthroplasty.

METHODS

A retrospective analysis was made in the data of 14 patients (14 hips) with Mallory typeⅡ periprosthetic femoral fractures associated with primary hip arthroplasty and treated with cerclage wires fixation between January 2010 and June 2011 (fracture group). Twenty-eight patients (28 hips) without periprosthetic femoral fractures associated with primary hip arthroplasty at the same stage were chosen as control group. The uncemented femoral prosthesis were used in 2 groups. There was no significant difference in gender, age, body mass index, and primary disease between 2 groups ( P>0.05). The operation time, intraoperative blood loss, and the complications were recorded. The Harris score was used to evaluate the hip function and the visual analogue scale (VAS) score was used to evaluate the pain degree of hip. According to the postoperative X-ray films of hips, Engh et al. standard was used to evaluate the fixed and stable status of the femoral prosthesis; the heterotopic ossification was observed; the time of fracture union was recorded.

RESULTS

The operation time of fracture group was significantly longer than that of control group ( t=-3.590， P=0.001). There was no significant difference in the intraoperative blood loss between 2 groups ( t=-1.276, P=0.209). All patients were followed up 64-75 months (mean, 69.5 months). Hip dislocation after operation occurred in 1 case of fracture group; delirium symptom and nonunion of incision occurred in 1 case and 1 case of control group, respectively. There was no significant difference in the Harris score and VAS score at 6 months and 5 years between 2 groups ( P>0.05). X-ray films showed that all fractures healed and the mean time of fracture union were 6.1 months (range, 3-12 months). There was no fracture nonunion or malunion evidently. There was no significant difference in X-ray score at 6 months and 5 years between 2 groups ( P>0.05). At last follow-up, cerclage wires displacement or breakage did not occur. Heterotopic ossification occurred in 2 cases of fracture group and in 1 case of control group.

CONCLUSION

Cerclage wires fixation can achieve the good mid-term effectiveness in treating Mallory typeⅡintraoprative periprosthetic femoral fractures associated with primary hip arthroplasty.