Retrograde intramedullary nailing below a hip arthroplasty prosthesis: a viable fixation option for periprosthetic and interprosthetic femur fractures

• Published in: International orthopaedics Vol. 44; no. 11; pp. 2283 - 2289
• Main Authors: Richard, Raveesh D., Natoli, Roman M., Sorkin, Anthony T., Virkus, Walter W., Gaski, Greg E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2020
• Subjects: Arthroplasty, Replacement, Hip - adverse effects; Bone Nails; Femoral Fractures - surgery; Femur; Fracture Fixation, Internal; Fracture Fixation, Intramedullary - adverse effects; Hip Fractures; Humans; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Periprosthetic Fractures - surgery; Retrospective Studies; Treatment Outcome; Periprosthetic; Nail; ORIF; Femu; Retrograde; Fracture; Intramedullary; internal fixation; Interprosthetic
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-020-04734-3

Background
Periprosthetic femur fractures (PPFF) distal to a femoral stem are traditionally treated with open reduction and internal fixation (ORIF) with plate and screws. To our knowledge, no studies exist comparing outcomes following ORIF vs retrograde intramedullary nails (RIMN) for this injury.
Methods
This is a retrospective comparison of PPFFs distal to a femoral stem treated by ORIF (
n
= 17) vs RIMN (
n
= 13). The primary outcome was unplanned re-operation.
Results
There was no difference in unplanned re-operation (17.6 vs 23.1%,
p
> 0.99), infection, nonunion, refracture, and alignment between groups. The RIMN group had shorter surgical time (89 vs 157 min,
p
< 0.01), less blood loss (137 vs 291 ml,
p
= 0.03), and greater obesity.
Conclusion
RIMN is a potential option for operative fixation of PPFF distal to a femoral stem worthy of additional study.