Abstract
We reviewed the treatment of 43 patients with rheumatoid arthritis and femoral neck fracture. Patients' average age was 66.4 (36–80) years and average duration of RA was 20.3 (4–42) years. Thirteen patients were treated with primary total hip arthroplasty (THA), and the clinical results were comparable to patients treated conservatively or by osteosynthesis. Eighteen patients were treated with primary bipolar hip prosthesis and after an average of 6.1 (1–13) years there was no acetabular destruction. However, long-term results were inferior to patients treated with THA. Nine patients were treated with osteosynthesis, of which two later had a hip prosthesis. Three cases with impacted fractures were treated conservatively with successful union in all.
Résumé
Nous avons étudiés le traitement d'une fracture du col du fémur chez 43 malades atteint de polyarthrite rhumatoïde. L'âge moyen des malades était 66,4 ans (36–80) et la durée moyenne d'évolution de la polyarthrite rhumatoïde étaient 20,3 ans (4–42). Treize malades ont été traités par arthroplastie totale de la hanche et les résultats cliniques étaient comparables à ceux des malades traités d'une manière conservatrice ou par ostéosynthèse. Dix-huit malades ont été traités avec une prothèse bipolaire. Après une moyenne de 6,1 ans (1–13) il n'y avait aucune destruction acetabulaire mais les résultats éloignés étaient inférieurs à ceux des malades traités avec PTH. Neuf malades ont été traités avec ostéosynthèse et deux d'entre eux ont du avoir secondairement une prothèse de la hanche. Trois cas de fracture engrenée ont été traités d'une manière conservatrice avec succés.
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Hasan, M.Y., Shinomiya, F., Okada, M. et al. Intracapsular hip fractures in patients with rheumatoid arthritis. International Orthopaedics (SICOT) 27, 294–297 (2003). https://doi.org/10.1007/s00264-003-0481-6
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DOI: https://doi.org/10.1007/s00264-003-0481-6