Morphological types of pathological fractures of the femoral neck in hemodialysed patients

Introduction. The long-term dialysed patients have metabolic bone disease. Aim of the work. The main purpose of this study was to describe the morphological types of femoral neck fractures in patients on long-term hemodialysis. The second aim was to determine the relation between the type of fracture and the patient’s epidemiological factors and survival of the prosthesis. Material and methods. Twenty-three hemodialysed patients with 26 pathological fractures of the femoral neck were analyzed. For each case, we studied the patomorphological type of fracture. All fractures were classified into four types. We observed chronic displaced fracture (type I) in 12 cases, chalk type fracture (type II) in 9 cases. Four fractures lines were localized through the intraosseous cyst (type III) and only one through periosseous amyloid deposit (type IV). Results. All cases were treated operatively by bipolar hemiarthroplasty. There were four radiological failures of the bipolar prostheses in type I fracture, three in type II and one in types III and IV. There were no significant relations between the type of fracture and the patient’s sex, age, BMI, PTH serum concentration or duration of dialysis. The risk of prosthesis migration was not dependent on the type of fracture in hemodialysed patients.