I read with interest the paper of Kamineni, Vindlacheruvu and Ware on Peri-prosthetic
femoral shaft fractures treated with plate and cable fixation, Injury 1999; 30: 261–268.
They should be congratulated for undertaking the care of these difficult and increasingly
common problems. I would, however, strongly question one of their central themes.
They state that fixation should be undertaken even in the presence of a loose stem.
Whilst open reduction and internal fixation is the preferred treatment when a fracture
occurs around a solidly fixed stem [
1
,
2
,
3
], this cannot be extended to the situation where the stem is already loose, and the
resulting motion or osteolysis have potentially contributed to the fracture.To read this article in full you will need to make a payment
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References
- Periprosthetic fractures after major joint replacement. Classification of the hip.Orthop. Clin. North Am. 1999; 30: 215-220
- The use of cortical allograft struts for fixation of fractures associated with well-fixed total joint prostheses.Semn. Arthroplasty. 1993; 4: 99-107
- Fractures of the femur after hip replacement.in: American Academy of Orthopaedic Surgeons Instructional Course Lectures. vol. 44. CV Mosby, St Louis1995: 293-304
- The Dall–Miles cable and plate system in the management of periprosthetic fractures.Injury. 1997; 28: 445-448
- Surgical management of intra- and post-operative fractures of the femur about the tip of the stem in total hip arthroplasty.J. Arthroplasty. 1996; 11: 709-717
Article info
Publication history
Accepted:
September 20,
1999
Received:
June 19,
1999
Identification
Copyright
© 2000 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
