“Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws
The incidence of periprosthetic fractures is increasing, presenting significant challenges due to patient longevity and the complexity of repeated surgeries. This report details the successful treatment of a previously unreported periprosthetic fracture pattern using a modified dynamic hip screw (DH...
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| Language: | English |
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Elsevier
2025-05-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644025000445 |
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| author | José-Vicente Andrés-Peiró Carlos Alberto Piedra-Calle Jordi Tomàs-Hernández Pablo S. Corona Carles Amat Jordi Teixidor-Serra |
| author_facet | José-Vicente Andrés-Peiró Carlos Alberto Piedra-Calle Jordi Tomàs-Hernández Pablo S. Corona Carles Amat Jordi Teixidor-Serra |
| author_sort | José-Vicente Andrés-Peiró |
| collection | DOAJ |
| description | The incidence of periprosthetic fractures is increasing, presenting significant challenges due to patient longevity and the complexity of repeated surgeries. This report details the successful treatment of a previously unreported periprosthetic fracture pattern using a modified dynamic hip screw (DHS) technique. Two cases involved patients with extracapsular fractures in short proximal femur segments above megaprostheses. The fractures were reduced and stabilized with a DHS device, complemented by 3.5 mm screws from a different manufacturer to achieve effective bicortical fixation around the thick stems. Early weight-bearing was initiated postoperatively, with both patients achieving fracture healing without mechanical complications. This approach highlights the importance of careful preoperative planning and the selection of appropriate fixation methods, particularly in complex cases where traditional solutions may not be viable. |
| format | Article |
| id | doaj-art-c5e906ff64a848c9be5529a08f0f0f26 |
| institution | Kabale University |
| issn | 2352-6440 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-c5e906ff64a848c9be5529a08f0f0f262025-08-20T03:45:06ZengElsevierTrauma Case Reports2352-64402025-05-015710116710.1016/j.tcr.2025.101167“Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screwsJosé-Vicente Andrés-Peiró0Carlos Alberto Piedra-Calle1Jordi Tomàs-Hernández2Pablo S. Corona3Carles Amat4Jordi Teixidor-Serra5Department of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain; Corresponding author at: Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain.Department of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, SpainDepartment of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, SpainDepartment of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, SpainDepartment of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, SpainDepartment of Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Reconstructive Surgery of the Locomotor System, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, SpainThe incidence of periprosthetic fractures is increasing, presenting significant challenges due to patient longevity and the complexity of repeated surgeries. This report details the successful treatment of a previously unreported periprosthetic fracture pattern using a modified dynamic hip screw (DHS) technique. Two cases involved patients with extracapsular fractures in short proximal femur segments above megaprostheses. The fractures were reduced and stabilized with a DHS device, complemented by 3.5 mm screws from a different manufacturer to achieve effective bicortical fixation around the thick stems. Early weight-bearing was initiated postoperatively, with both patients achieving fracture healing without mechanical complications. This approach highlights the importance of careful preoperative planning and the selection of appropriate fixation methods, particularly in complex cases where traditional solutions may not be viable.http://www.sciencedirect.com/science/article/pii/S2352644025000445Periprosthetic fractureMegaprosthesisProximal femurDynamic hip screw (DHS) |
| spellingShingle | José-Vicente Andrés-Peiró Carlos Alberto Piedra-Calle Jordi Tomàs-Hernández Pablo S. Corona Carles Amat Jordi Teixidor-Serra “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws Trauma Case Reports Periprosthetic fracture Megaprosthesis Proximal femur Dynamic hip screw (DHS) |
| title | “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws |
| title_full | “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws |
| title_fullStr | “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws |
| title_full_unstemmed | “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws |
| title_short | “Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws |
| title_sort | close to the tip with little bone to grip stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of dhs and 3 5 mm screws |
| topic | Periprosthetic fracture Megaprosthesis Proximal femur Dynamic hip screw (DHS) |
| url | http://www.sciencedirect.com/science/article/pii/S2352644025000445 |
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