Birmingham mid-head resection periprosthetic fractures: Case report

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Geriatric medicine

Background:

• Total hip arthroplasty in young patients presents challenges in implant selection.
• The Birmingham Mid-Head Resection (BMHR) prosthesis aims to preserve bone stock.
• Femoral neck fractures are a known complication of hip resurfacing, often necessitating revision surgery.

Purpose of the Study:

• To describe a rare complication associated with the BMHR prosthesis.
• To detail the surgical management of a unique periprosthetic fracture pattern.
• To review the available literature on BMHR prosthesis complications.

Main Methods:

• Presentation of an 81-year-old patient with a subtrochanteric fracture after BMHR prosthesis implantation.
• Surgical treatment via open reduction and internal fixation with a trochanteric plate and cerclages.
• Review of literature on fracture patterns in hip resurfacing.

Main Results:

• The patient sustained a subtrochanteric fracture, differing from typical femoral neck fractures seen with resurfacing.
• The fracture extended from the cervical to the subtrochanteric area.
• Successful surgical management was achieved with internal fixation.

Conclusions:

• BMHR prostheses, while preserving bone stock, can be associated with rare fracture patterns.
• The unusual fracture pattern in this case required a specific therapeutic approach.
• This case underscores the importance of considering atypical fracture presentations in periprosthetic management.