¹Aladashvili Pariko Merabovich*, ²Babalyan Volodimyr Oleksandrovich

TREATMENT OF PERIPROTHETIC FRACTURES OF THE FEMUR

Traumatology, Anesthesiology and Military surgery department

*Academic advisor: Associate professor, PhD, after doctoral candidate of traumatology, anesthesiology and military surgery department V.O.Babalyan

¹Kharkiv National Medical University MHP of Ukraine

Kharkiv, Ukraine.

²Kharkiv Medical Academy of Post-graduate Education MPH of Ukraine

Kharkiv, Ukraine

Introduction: The number of total hip arthroplasties is growing leading to periprosthetic fractures increase. The problem of treatment and prevention of periprosthetic fractures remains relevant.

Objective: To determine treatment principles of unstable periprosthetic fractures of the femur.

Materials and methods: The analysis of the clinical case of periprosthetic fracture of the right hip.

Result: Patient X 38 years old. According to the patient suffers from rheumatoid arthritis from age of 3 years. She was prescribed prednisolone.11.11.2006 (36 years). The total cementless arthroplasty of the right hip joint was performed. During the operation there was a periprosthetic fracture of the femur type 3 according to Vancouver's classification. The intraoperative fixation of the fracture with a cerclative cord was performed. Immobilization with gypsum coke bandage, strict bed rest, within 3 months, then orthosis 1-1.5 months, therapeutic exercises were prescribed. During the rehabilitation the false joint of the fracture zone has developed. 08.05.2007 Revision osteosynthesis with the Belinsky plate was performed. Walking on crutches is prescribed. In 2009 patient had a car accident. Patient denied right hip trauma.  
A fracture and migration of metal constructions on the control radiographs was found. Deformation of the right hip and shortening of the right lower limb up to 7 cm were found after further diagnostics. The metal construction was removed from the right hip. The intramedular osteotomy and osteosynthesis with individual nail of the periprosthetic fracture was performed. Patient was prescribed antibacterial and anticoagulant therapy. Patient was prescribed walking with crutches for 6 weeks with the full load after.

Conclusion: Intramedullar osteosynthesis allows achieving reliable fixation of the fracture, reintegration and fixation of cementless endoprosthesis in unstable periprosthetic fractures.