• Patrick Pflüger, Eftychios Bolierakis, Markus Wurm, Klemens Horst, Frank Hildebrand, and Peter Biberthaler.
• Department of Trauma Surgery, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany. Patrick.pflueger@tum.de.
• Eur J Trauma Emerg Surg. 2022 Jun 1; 48 (3): 1913-1918.

PurposeEffective therapy of periprosthetic femur fractures of the hip (PPF) are challenging due to patients' frailty and complexity of fracture patterns. The aim of this cohort study was to analyze the radiological and functional outcome following PPF.MethodsA retrospective, multicenter study in the period 2009-2019 of patients with PPF at two level I trauma centers in Germany was performed. PPF were classified according to the Vancouver classification system. Demographic data, American Society of Anesthesiologists (ASA) classification, type of surgery, complications, and reoperation rate were obtained from patient records. The functional outcome was assessed by the modified Harris-Hip Score (mHHS), general health using the EQ-5D, and radiological outcome by Beals & Tower (B&T) criteria.ResultsA total of 129 patients with a mean age of 79 years (range 43-102) were included. 70% of all patients were female and 68% of the patients had an ASA score ≥ 3. 20 patients suffered from a Vancouver A, 90 from a Vancouver B and 19 from a Vancouver C fracture. 14% of the patients died within the first 2 years after surgery. The reoperation rate after open reduction and internal fixation (ORIF) (n = 60) was 8% and after revision arthroplasty (RA) (n = 47) 30% (OR 3.4, 95% CI [1.21-10.2]). Mean mHHS (n = 32) was 53 ± 19.4 and EQ-VAS was 50 ± 24.6. According to B&T criteria, 82% of patients treated with ORIF (n = 17) and 62% after RA (n = 13) showed an excellent outcome.ConclusionPatients with a PPF of the hip are elderly and at increased operative risk. In cases with a stable prosthesis, ORIF provides good radiological outcome with low reoperation rates. In case of RA, the risk for revision surgery is higher.© 2021. The Author(s).

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