A systematic review of Vancouver B2 and B3 periprosthetic femoral fractures
| Autor: | Brigitte E. Scammell, Douglas J.C. Grindlay, Tanvir Khan, R.G. Pearson, Benjamin J Ollivere, A. R. J. Manktelow |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Reoperation
Vancouver classification medicine.medical_specialty Ovid medline medicine.medical_treatment Arthroplasty Replacement Hip Periprosthetic Prosthesis Design 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine medicine Internal fixation Humans Orthopedics and Sports Medicine 030212 general & internal medicine Surgical treatment 030222 orthopedics Revision arthroplasty business.industry Outcome measures Surgery Prosthesis Failure Hip Prosthesis Periprosthetic Fractures business Femoral Fractures Systematic search |
| Zdroj: | The bonejoint journal. (4 Supple) |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | Aims The aim of this study was to investigate the outcomes of Vancouver type B2 and B3 fractures by performing a systematic review of the methods of surgical treatment which have been reported. Materials and Methods A systematic search was performed in Ovid MEDLINE, Embase and the Cochrane Central Register of Controlled Trials. For inclusion, studies required a minimum of ten patients with a Vancouver type B2 and/or ten patients with a Vancouver type B3 fracture, a minimum mean follow-up of two years and outcomes which were matched to the type of fracture. Studies were also required to report the rate of re-operation as an outcome measure. The protocol was registered in the PROSPERO database. Results A total of 22 studies were included based on the eligibility criteria, including 343 B2 fractures and 167 B3 fractures. The mean follow-up ranged from 32 months to 74 months. Of 343 Vancouver B2 fractures, the treatment in 298 (86.8%) involved revision arthroplasty and 45 (12.6%) were treated with internal fixation alone. A total of 37 patients (12.4%) treated with revision arthroplasty and six (13.3%) treated by internal fixation only underwent further re-operation. Of 167 Vancouver B3 fractures, the treatment in 160 (95.8%) involved revision arthroplasty and eight (4.8%) were treated with internal fixation without revision. A total of 23 patients (14.4%) treated with revision arthroplasty and two (28.6%) treated only with internal fixation required re-operation. Conclusion A significant proportion, particularly of B2 fractures, were treated without revision of the stem. These were associated with a higher rate of re-operation. The treatment of B3 fractures without revision of the stem resulted in a high rate of re-operation. This demonstrates the importance of careful evaluation and accurate characterisation of the fracture at the time of presentation to ensure the correct management. There is a need for improvement in the reporting of data in case series recording the outcome of the surgical treatment of periprosthetic fractures. We have suggested a minimum dataset to improve the quality of data in studies dealing with these fractures. Cite this article: Bone Joint J 2017;99-B(4 Supple B):17–25. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|