PMC6664512_01
Radiograph of the initial left femoral neck fracture.
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She had undergone bipolar arthroplasty for left femoral neck fracture (Figures 1 and 2) and had been treated for osteoporosis with alendronate for 27 months after the bipolar arthroplasty.
Radiograph just after bipolar hip arthroplasty.
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She had undergone bipolar arthroplasty for left femoral neck fracture (Figures 1 and 2) and had been treated for osteoporosis with alendronate for 27 months after the bipolar arthroplasty.
Radiograph shows a periprosthetic femoral fracture. A transverse fracture line around the stem tip progresses across the femur.
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A periprosthetic simple transverse fracture at the level of the distal end of the stem was found (Figure 3).
Radiograph just after osteosynthesis with a locking plate on the lateral side of the femur.
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Internal fixation with a locking plate was performed at the hospital (Figure 4).
Radiograph 2 months before the periprosthetic fracture shows localized periosteal thickening of the lateral cortex at stem tip level.
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The retrospective radiographic analysis revealed that a periosteal thickening of the lateral cortex at the stem tip level had existed at least two months before the fracture (Figure 5).
Radiograph 9 months after the osteosynthesis showing nonunion at the site of the fracture.
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Radiographs showed a nonunion fracture with osteosclerotic changes in the left femoral shaft at the level of the stem tip (Figure 6).
Radiograph of the right (contralateral) femur. Femoral bowing was measured as the angulation between the proximal and distal quarters of the femoral diaphysis. It was 13 degrees in this case.
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Radiographs of her contralateral femur showed lateral bowing but no features of AFF (Figure 7).
Radiograph just after a revision surgery with a longer stem with a cemented technique and a locking plate on the lateral side of the distal femur.
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Osteosynthesis was performed with a locking plate for the distal femur (NCB Periprosthetic Femur Plate; Zimmer Biomet, Tokyo, Japan) and a cable system (Figure 8).
Radiograph 2 years after the revision surgery showing bone union achieved.
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Bony union was successfully achieved, and no issues were seen with the hemiarthroplasty (Figure 9).