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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

3.2K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Related Experiment Video

Updated: Jun 29, 2025

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

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Three Differing Methods of Treating Intraoperative Nondisplaced Calcar Fractures Demonstrate Similar Radiographic

Enrico M Forlenza1, John D D Higgins1, Timothy C Keating1

  • 1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois.

The Journal of Arthroplasty
|March 27, 2024
PubMed
Summary
This summary is machine-generated.

Managing intraoperative calcar fractures during total hip arthroplasty (THA) with cerclage cables (CCs), modular tapered-fluted stems (MTF), or fully-coated stems (FC) showed minimal subsidence. However, reoperation risks were higher than anticipated across all THA fracture management strategies.

Keywords:
calcar fracturecomplicationsperiprosthetic fracturesubsidencetotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Intraoperative calcar fractures during total hip arthroplasty (THA) require effective management strategies.
  • Current approaches include cerclage cables (CCs), modular tapered-fluted (MTF) stems, or fully-coated (FC) diaphyseal-engaging stems.

Purpose of the Study:

  • To compare the radiographic and clinical outcomes of three distinct intraoperative calcar fracture management strategies in THA.
  • To evaluate stem subsidence and complication rates for each treatment approach.

Main Methods:

  • Retrospective review of 50 patients with intraoperative calcar fractures from 9,129 primary THAs.
  • Patients were managed with CCs, MTF stems, or FC stems by three different surgeons.
  • Stem subsidence was assessed radiographically at 3 months and 1 year; complication rates were evaluated.

Main Results:

  • No significant difference in stem subsidence was observed at 3 months or 1 year across the CC, MTF, and FC groups.
  • Overall reoperation rate was 12%, with infections in the FC group and fractures in MTF/FC groups.
  • Instability requiring closed reduction occurred in the CC group.

Conclusions:

  • All three management strategies for intraoperative calcar fractures resulted in low radiographic stem subsidence.
  • The overall risk of reoperation associated with these THA fracture management techniques was higher than expected.