Shtonda D. Diagnosis and treatment of periprosthetic fractures of the femur after the hip joint replacement

The method of dual-energy x-ray absorptiometry in 40 patients studied the dynamic changes of bone tissue of the skeleton and femur around the femoral stem of the endoprosthesis in 5-10 years after the uncemented total hip replacement, depending on the age of the patient and the postoperative period. With the help of simulation computer 3D modeling, the feasibility of a differentiated approach to the planning and implementation of osteosynthesis of periprosthetic femoral fractures after hip replacement with different types of implants has been substantiated theoretically, and the stability of the osteosynthesis of this type of fracture has been performed under conditions of the preserved quality of bone tissue of the femur and osteoporosis. On the basis of computer calculations, the biomechanics of the interaction of the "stem endoprosthesis - femoral bone" and "stem endoprosthesis - bone fragments - implant" with the axial load of the limb with the average body weight of the human body are presented. In the clinical section of the work, the comparison of the effectiveness of traditional and advanced methods of treatment of periprosthetic fractures of the femoral bone after the hip replacement was performed. The results of treatment of 67 patients with periprosthesis of the femur fractures after the hip replacement were performed, which was performed at the clinical bases of the Department of Orthopedics and Traumatology № 1 of the P.L. Shupyk National Medical Academy of Postgraduate Education in the Kyiv City Clinical Hospital № 6 and № 8 for the period from 2009 to 2017.