Surgical treatment of periprosthetic femoral fractures following hip arthroplasty: Our institutional experience

Kinov, Plamen; Volpin, Gershon; Sevi, Roger; Tanchev, P; Antonov, Boris; Hakim, Geries

doi:10.1016/j.injury.2015.06.017

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…In addition to fracture type, the distribution of gender changed significantly after cross-matching. Almost equal distribution between men and women was recorded in the material primarily registered to the SHAR, in accordance with earlier register studies in Sweden, 9,20 as well as with a report by S. Johnson-Lynn et al 4 However, many studies 7,8,[21][22][23][24][25] have shown a female proportion of 59% or higher, which was verified by the current study after the data-linking. Almost the same share (60-40%), for primary THRs, was noticed both in our material and in the latest NARA-report (Nordic Arthroplasty Register Association).…”

Section: Discussionsupporting

confidence: 93%

Incidence and demographics of 1751 surgically treated periprosthetic femoral fractures around a primary hip prosthesis

et al. 2018

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Section: Discussionsupporting

confidence: 93%

Incidence and demographics of 1751 surgically treated periprosthetic femoral fractures around a primary hip prosthesis

et al. 2018

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“…Median surgical time seems higher for patients treated with RA, although only a trend toward significance can be seen (P ¼ .051). Median time of hospital stay was similar in both groups with 16 days (IQR: [12][13][14][15][16][17][18][19][20][21][22] in the LCP group compared to 15 days (IQR: [12][13][14][15][16][17][18][19][20][21][22] in the RA group (P ¼ .621). A total of 19 of 24 patients in the LCP group versus 24 of 35 patients in the RA group received blood units (P ¼ .548).…”

Section: Surgical Time Blood Transfusion Hospital Stay and Time Tomentioning

confidence: 85%

“…13,14 For the more technically challenging VTB2 fractures, RA with a long stem that bypasses the fracture remains the recommended procedure. 15,16 However, ORIF using LCP is a less complex and a less invasive procedure, especially in the management of polymorbid elderly patients. 17,18 We hypothesized that the ORIF with LCP could be a valid alternative if not a superior alternative to RA for the treatment of VTB2 fractures.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Periprosthetic Femoral Fractures Vancouver Type B2: Revision Arthroplasty Versus Open Reduction and Internal Fixation With Locking Compression Plate

Baum

Leimbacher

Kriechling

et al. 2019

Geriatr Orthop Surg Rehabil

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Introduction:The Vancouver algorithm recommends revision arthroplasty (RA) for Vancouver type B2 (VTB2) fractures. However, open reduction and internal fixation (ORIF) using locking compression plates (LCP) may be a valid and less invasive alternative treatment.Materials and Methods:Between January 2007 and March 2017, we retrospectively recruited all patients treated with either ORIF with LCP or RA for VTB2 fractures in our clinic. All of the following were reviewed: the length of hospital stay, the operating time, the need for blood transfusions during and/or after surgery, implant-related and patient-related complications, need for revision surgery, and the radiological outcome. Additionally, the functional outcome was investigated.Results:Fifty-nine patients were recruited. Thirty-five (59.3%) patients underwent RA, while 24 (40.7%) patients received ORIF with LCP. The median surgical time was 137.50 minutes in the LCP group compared to 160.00 minutes in the RA group ( P = .051). Three (12.5%) patients in the LCP group and 10 (28.6%) patients in the RA group experienced an implant-associated complication ( P = .131). Patient-related complications occurred in 3 (12.5%) patients in the LCP group versus 6 (17.1%) patients in the RA group ( P = .628). The mean preoperative Parker mobility score was 9 points in both groups and decreased in both groups to a mean of 5 points in the LCP and 7 points in the RA group.Discussion:Open reduction and internal fixation with LCP seems to be a less invasive procedure for VTB2 fractures in comparison to RA. It is a bone-sparing procedure that can be advantageous for further revision operations. Moreover, some fractures can only be anatomically reduced by ORIF with LCP, whereas for proximal fractures with a radiologically unambiguously loosened stem RA might be advantageous.Conclusion:In line with previously published studies, our data suggest that ORIF using LCP is a valid treatment option for VTB2 fractures.

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“…The management of Vancouver B fractures is still open to debate, with 1 study suggesting a 3-fold increase in mortality with fixation compared to revision arthroplasty [27]. In the case of Vancouver C fractures, open reduction with internal fixation is the standard recommended treatment, often with locked plating using cerclage wires or cables proximally to reinforce the construct [26,28,29]. The combination of a Vancouver C fracture in the presence of the antibiotic hip spacer is more difficult to address.…”

Section: Discussionmentioning

confidence: 99%

Treatment of a periprosthetic femur fracture around an antibiotic spacer with revision and an antibiotic plate

2019

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Infection following total hip arthroplasty can be a devastating complication, often necessitating a 2-stage surgery with the temporary placement of an antibiotic spacer. Fracture around this spacer is an uncommon complication that presents serious treatment challenges. Our manuscript details the successful surgical treatment of a previously unreported fracture around an antibiotic spacer, treated with revision to a hemiarthroplasty and placement of an antibiotic plate.

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Surgical treatment of periprosthetic femoral fractures following hip arthroplasty: Our institutional experience

Cited by 23 publications

References 22 publications

Incidence and demographics of 1751 surgically treated periprosthetic femoral fractures around a primary hip prosthesis

Incidence and demographics of 1751 surgically treated periprosthetic femoral fractures around a primary hip prosthesis

Treatment of Periprosthetic Femoral Fractures Vancouver Type B2: Revision Arthroplasty Versus Open Reduction and Internal Fixation With Locking Compression Plate

Treatment of a periprosthetic femur fracture around an antibiotic spacer with revision and an antibiotic plate

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