Periprosthetic Hip Fractures With a Loose Stem: Open Reduction and Internal Fixation Versus Stem Revision.

摘要: Abstract: Background It is recommended revision for Periprosthetic hip fractures (PPHF) with a loose stem. However, several authors have argued that under certain conditions, this fracture could be treated using osteosynthesis. The aim to compare stem versus internal fixation in the treatment of PPHF Methods All patients by osteosynthesis and between January 2009 2019 were included. We assessed hospital stay, ASA, Charlson Comorbidity Index (CCI), surgery time, blood transfusion, complications, reoperation rate, first-year mortality, radiological functional results. Results A total 57 included (40 osteosyntheses 17 revision), an average follow-up time 3.1 years. Their mean age was 78.47 years (R 45 - 92). In group, fewer required transfusion (32.5% vs. 70.6%), surgical times shorter (108 minutes 169 minutes), cost lower, both terms (€14,239.07 €21,498.45 operating room (€5,014.63 €8,203.34). No significant differences found groups rate or outcomes. Conclusions Compared revision, requires less has lower need transfusions, reduced cost. Stem remains choice stem, but V-B2 elderly low demand, high anaesthetic risk (ASA ≥ 3) many comorbidities (CCI 5) whom anatomic reconstruction possible, can viable option. Evidence level Historical cohorts. Level III