Modular prosthesis fracture in a patient with developmental dysplasia of the hip: a case report and literature review

BMC Musculoskeletal Disorders

Xiao-Kang Cheng¹  Hao Feng²  Yuan-Pei Cheng²  Yi-Han Zhong²  Yong-Bo Li²  Han Wu²  Yan-Bo Zhang²  Qian-Ru Zhang³ 

[1] Department of Orthopaedics, Affiliated Hospital of Chengde Medical University, 067000, Hebei, China;Department of Orthopaedics, China-Japan Union Hospital of Jilin University, 130033, Jilin, China;Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;

关键词: Total hip arthroplasty;    Developmental dysplasia of the hip;    Prosthesis fracture;    Nonunion;    Case report;   

DOI  :  10.1186/s12891-021-04325-2

来源: Springer

【 摘 要 】

BackgroundModular prosthesis fracture, especially distal femoral fracture, is a rare complication of total hip arthroplasty (THA). However, it is catastrophic, and may have a serious impact on the patients. A distal femoral prosthesis fracture in a patient with developmental dysplasia of the hip (DDH) with nonunion at the subtrochanteric osteotomy site has not yet been reported in any literature. This report presents the first such case, with a purpose of analyzing the causes of modular prosthesis fractures and nonunion of the osteotomy area, so as to provide orthopedic surgeons with experience and lessons.Case presentationWe report the case of a 52-year-old woman with the distal femoral prosthesis fracture after THA and subtrochanteric osteotomy for Crowe type IV DDH. The patient had severe pain in the left thigh and her activities were limited. Plain radiographs revealed fracture of the left distal femoral prosthesis and nonunion in the subtrochanteric osteotomy region of the left femur. After a revision of the THA, the patient’s symptoms were resolved.ConclusionsA prosthesis fracture combined with nonunion at the subtrochanteric osteotomy site is a rare complication. Modular THA combined with a subtrochanteric osteotomy in the treatment of Crowe type IV DDH should reduce the damage to blood supply and avoid further nonunion of the osteotomy area, which may otherwise lead to modular prosthesis fractures. A detailed preoperative plan and suitable rehabilitation program may help minimize the occurrence of subtrochanteric osteotomy nonunion and reduce complications, including femoral prosthesis fractures, in patients with DDH.

【 授权许可】

CC BY