Managing Periprosthetic Fracture of the Proximal Femur Using Total Hip Arthroplasty in a Patient with Sequelae of Poliomyelitis: Case Report and Literature Review.

INTRODUCTION

Patient with poliomyelitis can have long-term sequelae such as paralysis and muscle weakness in their lower limb caused by motor atrophy and degradation of motor and autonomic neurons. Patients can also develop osteoporosis, causing instability. This leads to a greater risk of falls and fractures, such as hip fractures. There are difficulties and risks in doing management, especially doing total hip arthroplasty (THA) in poliomyelitis patients due to differences in anatomy and function of the lower limb.

CASE REPORT: A 70-year-old woman came to the hospital with pain in her left hip after she slipped and landed on her left hip first 5 h before. She underwent a femoral surgery 30 years ago and has a history of polio. She was diagnosed with a periprosthetic fracture at the left femoral neck post-open reduction and internal fixation plate and screws with equinus deformity at the left ankle due to poliomyelitis and osteopenia. She then undergoes implant removal and total hip replacement with cerclage wire. The surgery showed excellent results, with no sign of infection or dislocation, and significant pain improvement. Further physiotherapy will lead to an improvement in motoric function.

CONCLUSION

THA in patients with poliomyelitis presents with several complications and difficulties. However, if the indication outweighs the risk, it should be done with good surgical planning and close post-operative follow-up and rehabilitation.