Vancouver B2 periprosthetic femoral fractures: a comparative study of stem revision versus internal fixation with plate
| Autor: | Mauro Spina, Andrea Scalvi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Radiography Arthroplasty Replacement Hip Periprosthetic 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine Quality of life Bone plate medicine Internal fixation Humans Orthopedics and Sports Medicine 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over 030222 orthopedics Retrospective review business.industry Retrospective cohort study Middle Aged Surgery Treatment Outcome Harris Hip Score Female Hip Prosthesis Periprosthetic Fractures business Bone Plates Femoral Fractures |
| Zdroj: | European journal of orthopaedic surgerytraumatology : orthopedie traumatologie. 28(6) |
| ISSN: | 1432-1068 |
| Popis: | The aim is to compare stem revision versus internal fixation with plate in the treatment of Vancouver B2 periprosthetic femoral fractures. This is a retrospective review of 34 consecutive patients admitted from June 1998 to May 2017. One patient was treated conservatively, 11 with stem revision (group 1), 20 with plate, screws and cerclage (group 2), one patient with cerclage alone and another by Girdlestone procedure. We assessed surgical complications, mortality within 1 year, functional outcome with Harris Hip Score and radiographic outcome with Beals and Tower’s criteria. At an average follow-up of 30.1 months in group 1, we had 36.4% of patients with complications, HHS of 66.8, radiographic outcome “excellent-good” in 91% of cases. In group 2 we had 25% of patients with complications, HHS of 71.8, radiographic outcome “excellent-good” in 80% of cases. There were no significant differences in 1-year mortality between the two groups. In group 2, the best outcomes were obtained in uncemented straight stems with Johansson type 1 fracture and in cemented polished stems with stem detachment from the cement–bone complex. Whatever treatment was adopted, there was an overall worsening in quality of life. Stem revision remains the treatment of choice in Vancouver B2 fractures, but, in selected cases, internal fixation with plate, screws and cerclage can be a viable alternative option. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink