L’osteosintesi nelle fratture periprotesiche di gi

Authors: Roberto Sciortino Angelo Leonarda

Publish Date: 2015/07/15

Volume: 29, Issue: 2, Pages: 153-159

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Abstract

Periprosthetic fractures are becoming increasingly common nowadays Standard treatment includes revision of the prosthetic implant albeit this option typically leads to complex and lengthy interventions Removal of the prosthesis often leads to significant bleeding which has particular relevance for elderly subjects with significant comorbidities Osteosynthesis using plates or nails is the second choice albeit limitedly to the femoral portion as it may not be used in the tibial portion Our experience has prompted us to use LISS plates for fracture reduction which allows for better management of complex multifragmentary fractures even in proximity to the prosthetic implantAn increase in the incidence of fractures between the prosthetic stem and intramedullary nails has been observed The use of nails is preferred thanks to the shorter surgical times in case of uncomplicated fractures On the other hand plates allow for fracture stabilisation especially with distal fractures with the restoration of limb length without any need for lengthy incisions or damage to periskeletal soft tissues and minimum risk of perioperative bleeding better patients compliance Furthermore they allow for better control of possible axial deviations of the segment even in case of rotary movements not always fixed by the application of retrograde nails On the basis of published evidence the use of plates seems to be preferable over nailing Lastly there is the need to emphasise that attentive and diligent surgical techniques at the time of the prosthetic implant largely reduces the incidence of such fracturesTutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio

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