Periprosthetic Hip Fracture due to Ballistic Injuries

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Ballistics Medicine

Background:

• Periprosthetic fractures (PFs) are a frequent complication following total hip arthroplasty, often necessitating revision surgery.
• Ballistic injuries (BIs) causing PFs in total hip arthroplasty have not been previously reported in the literature.
• Current literature lacks established guidelines for managing PFs secondary to ballistic trauma.

Observation:

• Two cases of periprosthetic hip fractures caused by ballistic injury in total hip arthroplasty patients were successfully treated.
• The study includes a literature review on open fractures resulting from ballistic injuries.
• Clinical outcomes and evidence-based management strategies for these specific injuries are presented.

Findings:

• Successful management of a Vancouver B1 femoral periprosthetic fracture due to ballistic injury was achieved.
• The treatment protocol involved early antibiotic administration, thorough surgical debridement, and osteosynthesis.
• Techniques employed included the use of a variable angle locking plate, structural allograft, cerclage wires, and negative pressure wound therapy.

Implications:

• This study provides a foundational management approach for rare periprosthetic hip fractures caused by ballistic trauma.
• The described treatment protocol offers a viable option for surgeons managing similar complex orthopedic injuries.
• Further research into ballistic injury-specific periprosthetic fractures may refine treatment protocols and improve patient outcomes.