Abstract
Background
The periprosthetic fracture of cemented polished tapered stems is occasionally called
a “unique” or “axe splitter” fracture. However, there has been insufficient evidence
regarding the association between the radiographic findings prior to incidence and
this cumbersome fracture. To determine if there are any radiographic interpretations
associated with this fracture pattern, we report the five SC-stem cases with total
hip arthroplasty.
Methods
We investigate the patient characteristics and serial radiographs of five fracture
cases and evaluate the time-dependent specific radiographical changes around the stem
between pre-arthroplasty and fracture.
Results
Fractures developed at 3.5–6.4 years after surgery with low-grade injury or with no
particular incentive. Femoral cortical hypertrophy at the distal medial side around
the stem was observed in all cases before the development of fractures, at 2–6 years
after primary surgery. The duration between cortical hypertrophy appearance to the
development of fracture was 0.4–3.1 years.
Conclusions
The appearance of this zone-specific cortical hypertrophy might play a key role in
the occurrence of periprosthetic fractures. Further studies with larger sample sizes
should be conducted to elucidate this eccentric periprosthetic fracture.
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Article Info
Publication History
Published online: September 28, 2022
Accepted:
September 2,
2022
Received in revised form:
August 20,
2022
Received:
July 19,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
