[Surgical complications following implantation of femur head prostheses in a traumatology patient sample. Prevention and therapy].

At the 1st University-Clinic of Traumatology, Vienna, 420 patients with a medial fracture of the femoral neck received a femoral neck prosthesis (59 male, 361 female, phi age 81.3 years; range: 60-97 years). Severe early complications were fractures of the femoral shaft in 1.19%, that healed without problems after cerclage and plate osteosynthesis, and early infections in 3.1%. The rate of infections can be reduced to 1% prophylactic administration of antibiotics, surgery in an laminar airflow operating theater, and by the use of cement containing antibiotics. Dislocation of the prosthesis was observed in 2 patients (0.47%). the low rate of dislocation appears to be due to the antero-lateral operative approach according to Watson-Jones without osteotomy of the trochanter as well as to the precise technique of implantation of the prosthesis. More frequent late complications were periarticular calcification in 20 cases (4.7%) and protrusion in 18 cases (4.28%). However, only one out of the patients with calcification is restricted in his movements, and only 3 out of the patients with protrusion do complain of symptoms. The low rate of symptomatic protrusions is explained by a correct level of resection, by the implantation of a head prosthesis with appropriate dimensions and by the exclusion of patients with arthrosis of the hip or severe osteoporosis from the implantation of a femoral head prosthesis.