创伤与治疗杂志

Reduced Leg Lengthening found with a Modular Hip Hemiarthroplasty Stem versus the Monoblock Equivalent

Abstract

Pegrum J, Giannakakis N, Subramanian , Abbas D and Pearce O

The frequency of hip fractures are increasing in the globally. Cemented implants offer less pain and improved mobility post operatively. To date there has been no comparison between The Exeter Trauma Stem (ETS), which is a monoblock single size stem versus the Joint Replacement Instrumentation (JRI), a modular cemented hip used in the treatment of intracapsular fracture neck of femur fractures. It was postulated that the monoblock single size stem would be more difficult to insert in smaller femoral canals, and as such would have a greater tendency to lengthen the leg and greater incidence of calcar fractures. Over a 2 year period we have reviewed, the operative complications and radiological outcomes of the JRI hip hemiarthroplasty stem with a matched group of ETS implants. The study
highlights the one-size-fits-all ETS system is more likely to be placed longer than a modular JRI system (p=0.01). There was no statistical difference in calcar fractures between the two prostheses. There were 40/99 JRI implants (40%) patients which required a smaller prosthesis than the ETS, these patients may have been over lengthened if the ETS was used. Careful radiographic pre-operative evaluation is required in order to avoid over lengthening the ETS prosthesis in patients with a narrow canal. A modular prosthetic design offers a valuable alternative to such a scenario.