The Forgotten Hip Fracture: Outcomes Of Lower Limb Periprosthetic Fractures

IntroductionThere is an increasing prevalence of primary hip fractures and peri-prosthetic hip and knee fractures. There is uncertainty about how best to manage peri-prosthetic fractures, and they do not attract the same financial incentives and management guidelines. MethodsA retrospective review of medical records was performed at a large academic teaching hospital between October 2014 and September 2016. Seventy-three patients who sustained periprosthetic fractures of the hip and knee were identified. These were compared with outcomes for the hospital recorded on the National Hip Fracture Database. ResultsThere were difference in the baseline characteristics between the two groups, with PPF patients having a younger age, lower frailty score and being more likely to be female. There were lower rates of pre-operative assessments for the PPF group. Given the differences in baseline characteristics, their post-operative scores could not be reliably statistically compared. DiscussionPatients with PPFs may have different characteristics and outcomes to patients presenting with primary hip and knee fractures. More work is needed to better characterise this patient group. Conclusionpatients sustaining periprosthetic fractures represent a distinct patient group to those with primary hip fractures.