Post-polio syndrome is characterized by a late functional deterioration (usually after >=15 years from the initial
infection) in patients with a history of paralytic
poliomyelitis infection, and it is defined by the March of Dimes criteria. Patients with
post-polio syndrome are at increased risk for falls and associated hip and
femoral fractures as a result of lower bone mineral density, decreased lean muscle mass, and musculoskeletal
deformities. Current evidence suggests that treatment modalities for
femoral fractures should emphasize fixation that allows early progressive weight-bearing and ambulation to optimize functional outcomes. Good results after hip
arthroplasty have been described with both cemented and uncemented implants in patients who have been treated for
osteoarthritis, but there has been little evidence guiding hip fracture management. Anatomic challenges that are encountered are osteoporotic bone, a valgus neck-shaft angle, increased femoral anteversion, and a small femoral canal diameter.
Intramedullary nailing of hip and
femoral fractures can be challenging due to the small femoral canal diameter that frequently is encountered. Alternative methods of fixation have shown promising results. These include the use of sliding hip screws for hip fracture management and fixed-angle locking plates for hip and
femoral fracture management.