Periprosthetic femoral fractures associated with hip arthroplasty.

摘要

I read with interest the article "Periprosthetic Femoral Fractures Associated With Hip Arthroplasty" (http://www.orthosu-persite.com/view.aspx?rid=78070) in the December 2010 issue of Orthopedics. The paper was well organized and well written. However, a specific entity is missing: iatrogenic intraoperative crack or fracture. This is a well-known entity that has been recognized since noncemented press-fit implants were introduced.In our unpublished series, we estimated the occurrence of iatrogenic intraoperative fracture-at-approximately % to 2% as a rale at the calcar, but also at the borders of the greater trochanter. It was noticed more frequently in revisions, but was present in primary procedures as well. It is often taken care of by cerclage wire with or without cementing the stem. This entity is occasionally unrecognized and leads to postoperative pain or late propagation into fracture.