Wednesday, June 22, 2016

Periprostheric femur fracture - Revision and ORIF

This is a complex hip fracture case. An elderly lady had a hip replacement a few years ago. Here are her post-op x-rays.
She did well after the surgery until she fell a few years later.
This is what the x-rays look like.

As you can see in the x-rays, there is a fracture of the femur around the hip implant. This is called a periprosthetic femur fracture. There are multiple fracture fragments around the proximal femur. The hip stem seems to have come out of the femur through the fracture and is no longer attached to the femur.
The best treatment for this type of problem is to remove the femoral component of the hip replacement and place a new, longer one and to fix the fracture with cables. This is called revision hip arthroplasty(replacement) with open reduction and internal fixation(ORIF).
The Biomet Arcos Modular Femoral Revision System was used for this surgery. The Arcos is assembled with different sized parts inside the femur during the surgery. It allows the surgeon to customize the implant for the specific surgical application.
Biomet Arcos(c)
Here is a x-ray showing successful revision of the femoral implant and cerclage cable fixation of the femur fracture.

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