Jun-Wen Wang and Ching-Jen Wang
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan

Between 1993 and 1998, 15 patients with periprosthetic fractures of the femur after hip arthroplasty were treated using deep-frozen cortical strut allografts as an adjunct support after internal fixation or revision arthroplasty. According to the Vancouver classification system, there were 7 type B1, 2 type B2, 4 type B3 and 2 type C fractures. Seven patients had severe osteopenia, 10 patients had bone defects between 2 to 7 cm and 2 were associated with infection. Nine patients had internal fixation of the fracture using a compression plate, and 6 had revision arthroplasty using a long-stemmed femoral prosthesis. The average length of the allograft was 13.9 cm. At an average follow-up of 31 months, all the patients had a satisfactory functional result except one who had a leg length discrepancy of 4 cm due to multiple operations. There were no non-unions, malunions or infections. The fractures healed between 10 to 24 weeks (average, 15.6 weeks). In conclusion, a cortical strut allograft associated with internal fixation can be an effective method of treating periprosthetic fractures of the femur after hip arthroplasty.

Key Words: periprosthetic fracture; cortical strut allograft; revision arthroplasty