Concepts and Potential Future Developments for Treatment of Periprosthetic Proximal Femoral Fractures.

摘要: Periprosthetic proximal femoral fractures are a major challenge for the orthopaedic surgeon, with continuously increasing incidence due to aging populations and concordantly numbers of total hip replacements. Surgical decision-making mainly depends on stability arthroplasty, quality bone stock. As patients final outcomes depend early mobilization, high primary construct is particular relevance. Osteosynthetic procedures usually applied stable while loosened endoprosthesis commonly require revision arthroplasty. Osteoporotic insufficient anchoring substance screws poses one concern cases well-fixed arthroplasties. Complication rates perioperative mortality have remained unacceptably high, emphasizing need new innovations in treatment periprosthetic fractures. Transprosthetic drilling through stem as most solid reliable part patient might represent promising future approach, auspicious results recent biomechanical studies.