Periprosthetic Fractures of the Femur during the Operation of Primary Total Hip Arthroplasties

Objective  To determine the incidence of periprosthetic femoral fractures during the operation in primary hip arthroplasties and correlate them with the inherent risk factors associated with patients, implants, and the diagnosis of coxarthrosis and/or femoral neck fractures. Methods  Cross-sectional study, with retrospective analysis of medical records and image exams of patients operated between 2014 and 2019. The variables analyzed followed those proposed by the world literature, namely: age, sex, Dorr index, surgical indication, Vancouver classification, location, type of fixation (cemented or non-cemented), implant model used, intraoperative diagnosis, and corresponding treatment approach. All surgeries used the same posterolateral access route and were performed by the same group of surgeons. Results  Within the sample of 2,217 arthroplasties (2,154 patients), 12 fractures (0.56%) were identified in 12 patients. The sample consisted of 8 females and 4 males, with an average age of 62.53 years. In all diagnosed cases, protective cerclages were added at the level of the lesser trochanter and/or the greater trochanter, and, in 3 cases, there was a change from uncemented to cemented femoral stems and only 1 required revision. Conclusion  Data Analysis Allows Us To State That The Risk Of Intraoperative Periprosthetic Fracture Is Greater In Women And With The Use Of Cementless Stems. The Occurrence Of These In This Study Had A Rate Of Less Than 1%.