Cervico-Cephalic Arthroplasty with Peroperative Fractures: Analysis of Lesions and Management

Abstract

Objective: Our study aimed at studying the nature of iatrogenic bone lesions during cervico-cephalic arthroplasties in order to carry out an appropriate treatment.
Patients and Methods: This retrospective study included 6 patients who presented osseous lesions found either intraoperatively or immediate postoperative radio-graphs. Specifically, there were two males and four females with a median age of 72 years (62 -81 years),with 5 pseudarthrosis and one fracture of femoral neck. Austin Moore prosthesis have been implanted in all the patients. From the records, we documented the type of fracture, specific treatment, local evolution and the patient's outcome.
Results: we observed two great trochanter fractures, one calcar fracture (fissure), one small trochanter avulsion, and two metaphysis fractures. The duration of hospitalization average was 17.5 days (6-34 days). One hematoma occurred during the course of treatment. Two patients were operated (one's great trochanter was strapped by wire steel, and another was treated by screws at 24-postoperative day). Two patients died at home. One patient remained in the wheelchair, and three fully recovered with an average score of ''Postel Merle d'Aubigné'' 12.25 (8-13).
Conclusion: iatrogenic fractures during arthroplasty represent a pejorative factor in the expected outcome. The surgical technique should be carefully done along with smooth handling preparation and reduction in osteoporotic elderly patients with cervical pseudarthrosis.

Key words: Art hroplasty- Moore prosthesis - peroperative fracture - complications.