Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-02-2018 | Original Article • HIP - ARTHROPLASTY

The Baba classification focused on implant designs is useful in setting the therapeutic strategy for interprosthetic femoral fracture

Authors: Tomonori Baba, Kazuo Kaneko, Yasuhiro Homma, Hironori Ochi, Yu Ozaki, Taiji Watari, Mikio Matsumoto

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2018

Abstract

Purpose

The purpose of this study was to investigate the clinical outcomes of femoral fracture with implants on the proximal and distal sides to verify whether actual fracture morphologies follow the fracture types of Baba classification focusing on implant designs useful for periprosthetic femoral fracture.

Methods

Prosthesis was present in 85 with periprosthetic femoral fractures. Excluding 73 patients with fracture around the femoral stem or fracture of the TKA femoral component alone, 12 patients with 14 legs with both implants were investigated. All patients were radiographically assessed for implant stability according to the Baba classification. For clinical evaluation, intra- and postoperative complications, the operation time, and intra-operative blood loss were investigated.

Results

The Baba classification fracture type showed the implant as unstable and stable types in 3 and 11 legs, respectively. The consistency rate between the Baba classification-based judgment of plain radiograms acquired at the time of injury and actual surgical findings was 100%. As a result of treatment according to the Baba classification, bone union was achieved in all patients. There were no intra- or postoperative complications.

Conclusions

Applying the Baba classification, implant stability could be sufficiently evaluated in not only periprosthetic femoral fractures following hip arthroplasty, but also interprosthetic femoral fractures, thereby verifying its usefulness in setting the treatment strategy.

Della Rocca GJ, Leung KS, Pape HC (2011) Periprosthetic fractures: epidemiology and future projections. J Orthop Trauma 25:S66–S70CrossRefPubMed

Rorabeck CH, Taylor JW (1999) Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am 30:209–214CrossRefPubMed

Solarino G, Vicenti G, Moretti L, Abate A, Spinarelli A, Moretti B (2014) Interprosthetic femoral fractures—a challenge of treatment. A systematic review of the literature interprosthetic femoral fractures. Int J Care Inj 45:362–368CrossRef

Kenny P, Tice J, Quinlan W (1998) Interprosthetic fracture of the femoral shaft. J Arthroplasty 13:361–364CrossRefPubMed

Weiser L, Korecki MA, Sellenschloh K, Fensky F, Püschel K, Morlock MM, Rueger JM, Lehmann W (2015) Interposition sleeve as treatment option for interprosthetic fractures of the femur: a biomechanical in vitro assessment. Int Orthop 39:1743–1747CrossRefPubMed

Sah AP, Marshall A, Virkus WV, Estok DM 2nd, DellaValle CJ (2010) Interprosthetic fractures of the femur: treatment with a single-locked plate. J Arthroplasty 25:280–286CrossRefPubMed

Hou Z, Moore B, Bowen TR, Irgit K, Matzko ME, Strohecker KA, Smith WR (2011) Treatment of interprosthetic fractures of the femur. J Trauma 71:1715–1719PubMed

Duncan CP, Masri BA (1995) Fractures of the femur after hip replacement. Instr Course Lect 44:293–304PubMed

Su ET, DeWal H, Cesare PE (2004) Periprosthetic femoral fractures above total knee replacement. J Am Acad Orthop Surg 12:12–20CrossRefPubMed

10.

Platzer P, Schuster R, Luxl M, Widhalm HK, Eipeldauer S, Krusch-Mandl I et al (2011) Management and outcome of interprosthetic femoral fractures. Injury 42:1219–1225CrossRefPubMed

11.

Laurer HL, Wutzler S, Possner S, Geiger EV, El Saman A, Marzi I, Frank J (2011) Outcome after operative treatment of Vancouver type B1 and C periprosthetic femoral fractures: open reduction and internal fixation versus revision arthroplasty. Arch Orthop Trauma Surg 131:983–989CrossRefPubMed

12.

Baba T, Homma Y, Momomura R, Kobayashi H, Matsumoto M, Futamura K, Mogami A, Kanda A, Morohashi I, Kaneko K (2015) New classification focusing on implant designs useful for setting therapeutic strategy for periprosthetic femoral fracture. Int Orthop 39:1–5CrossRefPubMed

13.

Baba T, Homma Y, Ochi H, Kobayashi H, Matsumoto M, Sakamoto Y, Kuwahara H, Maeda K, Kaneko K (2015) Higher reliability and validity of Baba classification with CT imaging and implant information for the periprosthetic femoral fractures. Int Orthop 39:1695–1699CrossRefPubMed

14.

Duncan CP, Haddad FS (2014) The unified classification system (UCS): improving ouyr understanding of periprosthetic fractures. Bone Jt J 96B:713–716CrossRef

15.

Pires RE, de Toledo Lourenço PR, Labronici PJ, da Rocha LR, Balbachevsky D, Cavalcante FR, de Andrade MA (2014) Interprosthetic femoral fractures: proposed new classification system and treatment algorithm. Injury 45:S2–S6CrossRefPubMed

16.

Corten K, Vanrykel F, Bellemans J, Frederix PR, Simon JP, Broos PL (2009) An algorithm for the surgical treatment of periprosthetic fractures of the femur around a well-fixed femoral component. J Bone Jt Surg Br 91:1424–1430CrossRef

17.

Naqvi GA, Baig SA, Awan N (2012) Interobserver and intraobserver reliability and validity of the Vancouver classification system of periprosthetic femoral fractures after hip arthroplasty. J Arthroplasty 27:1047–1050CrossRefPubMed

18.

Ochs B, Stöckle U, Gebhard F (2012) Interprosthetic fractures—a challenge of treatment. Eur Orthop Traumatol 4:1–7

19.

Lehmann W, Rupprecht M, Hellmers N, Sellenschloh K, Briem D, Puschel K et al (2010) Biomechanical evaluation of peri- and interprosthetic fractures of the femur. J Trauma 68:1459–1463CrossRefPubMed

20.

Iesaka K, Kummer FJ, Di Cesare PE (2005) Stress risers between two ipsilateral intramedullary stems. J Arthroplasty 20:386–391CrossRefPubMed

21.

Soenen M, Migaud H, Bonnomet F, Girard J, Mathevon H, Ehlinger M (2011) Interprosthetic femoral fractures: analysis of 14 cases. Proposal for an additional grade in the Vancouver and SoFCOT classifications. Orthop Traumatol Surg Res 97:693–698CrossRefPubMed

22.

Ebraheim N, Carroll T, Moral MZ, Lea J, Hirschfeld A, Liu J (2014) Interprosthetic femoral fractures treated with locking plate. Int Orthop 38:2183–2189CrossRefPubMed

23.

Baba T, Homma Y, Morohashi I, Maruyama Y, Shitoto K, Kaneko K (2015) Is internal fixation using a reversed condylar locking plate useful for treating Vancouver type B1 periprosthetic femoral fractures? Eur Orthop Traumatol 6:137–143CrossRef

24.

Urabe K, Mahoney OM, Mabuchi K, Itoman M (2008) Morphologic differences of the distal femur between Caucasian and Japanese women. J Orthop Surg 16:312–315CrossRef

25.

Maratt J, Schilling PL, Holcombe S, Dougherty R, Murphy R, Wang SC, Goulet JA (2014) Variation in the femoral bow: a novel high-throughput analysis of 3922 femurs on cross-sectional imaging. J Orthop Trauma 28:6–9CrossRefPubMed

Title: The Baba classification focused on implant designs is useful in setting the therapeutic strategy for interprosthetic femoral fracture
Authors: Tomonori Baba
Kazuo Kaneko
Yasuhiro Homma
Hironori Ochi
Yu Ozaki
Taiji Watari
Mikio Matsumoto
Publication date: 01-02-2018
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2018
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-017-2045-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The Baba classification focused on implant designs is useful in setting the therapeutic strategy for interprosthetic femoral fracture

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Morphological anatomy of thoracolumbar nerve roots and dorsal root ganglia

Prevalence of low back pain among health sciences students

Delayed sciatic nerve compression following hamstring injury

Low incidence of postoperative urinary retention with the use of a nurse-led bladder scan protocol after hip and knee arthroplasty: a retrospective cohort study

Pelvic fractures in the Netherlands: epidemiology, characteristics and risk factors for in-hospital mortality in the older and younger population

Clinical and instrumental evaluation of two different regimens of tranexamic acid in total hip arthroplasty: a single-centre, prospective, randomized study with 80 patients