Journal of orthopaedic trauma vol:10 issue:7 pages:515
I read with much interest the article by Stappaerts et al., in which they compare the treatment of unstable peritrochanteric fractures with a Vandeputte (VDP) prosthesis versus a compression hip screw in a prospective randomized study. Mechanical complications mainly occurred in those patients who were treated with a compression hip screw and that involved severe fracture redisplacement. In this study, however, the patients were only followed for 3 months.
I would like to draw attention to the fact that in the past year we have seen three patients with a mechanical failure of the VDP prosthesis 3 years following implantation. In each patient, stem fracture occurred in the proximal slim part of the prosthetic stem. Two patients needed revision. One patient was wheelchair bounded and considered unfit for further surgery. The titanium head of the prosthesis was severely burnished and had caused considerable cup wear in both patients who had the revision. The distal well-fixed slender part of this stem is difficult to remove and required a transfemoral approach in one patient.