H. Schmotzer et al., SURGICAL-MANAGEMENT OF INTRAOPERATIVE AND POSTOPERATIVE FRACTURES OF THE FEMUR ABOUT THE TIP OF THE STEM IN TOTAL HIP-ARTHROPLASTY, The Journal of arthroplasty, 11(6), 1996, pp. 709-717
Six techniques for the surgical management of fractures of the femur a
bout the tip of the stem of a total hip arthroplasty were evaluated. S
even embalmed human femurs were prepared to receive the correct-size f
emoral component of a total hip system. A transverse osteotomy was per
formed at the level of the tip of the stem. Stability and strength of
each reconstruction were tested on each femur under semidynamic loadin
g conditions. This study showed that cementless revision to a long-ste
m prosthesis does not provide adequate stability. The highest strength
and stability were achieved by supplementing the long-stem conversion
with allograft struts and cable cerclage. Good results were obtained
by lateral compression plating with unicortical screws proximally. Fai
lure was due to pull-out of the proximal screws.