Proximal Femoral Fracture After Hip Resurfacing Managed with Blade-Plate Fixation

Abstract

Periprosthetic and proximal femoral fractures that occur after hip resurfacing are a challenging problem which, with the increasing popularity of resurfacing arthroplasty, is likely to increase in frequency. In the presence of a well-fixed acetabular component, periprosthetic femoral neck fractures about a hip resurfacing implant may be successfully managed by isolated revision of the femoral component and retention of the socket. However, successful internal fixation of the fracture would allow retention of the femoral implant and salvage of a previously well-functioning resurfacing prosthesis. When the resurfacing femoral component is retained, however, the presence of the implant stem, which is centrally located in the femoral neck, causes difficulty in placing the typical implants (e.g., a screw-plate device or a cephalomedullary nail) that are used in the management of intertrochanteric and proximal femoral fractures. We present the case of a patient in whom an intertrochanteric femoral fracture distal to a hip resurfacing implant was successfully managed by internal fixation with use of an angled blade plate. The patient was informed that data concerning the case would be submitted for publication, and he consented. A sixty-seven-year-old man with end-stage osteoarthritis underwent left hip resurfacing through a posterior approach and with use of a Cormet (Corin Group, Cirencester, United Kingdom) metal-on-metal resurfacing prosthesis. The femoral component was fixed with Simplex polymethylmethacrylate cement (Stryker, Limerick, Ireland), which was poured into the prosthesis early …