Top

International Orthopaedics

Published in:

01-05-2012 | Original Paper

Management of Vancouver B2 and B3 femoral periprosthetic fractures using a modular cementless stem without allografting

Authors: Daniel Neumann, Christoph Thaler, Ulrich Dorn

Published in: International Orthopaedics | Issue 5/2012

Abstract

Purpose

We reviewed our experience with the management of B2 and B3 femoral periprosthetic fractures using a distally fixed modular femoral stem in 55 patients.

Methods

All periprosthetic fractures were managed immediately after injury without using allograft; 53 hips were available for a mean follow up of 67 months.

Results

All fractures united, and the mean Harris hip score at the last follow up was 72. Subsidence was noted in two patients (4%) within six months postoperatively and required revision surgery. One patient developed peroneal nerve palsy. Two hips dislocated and were managed by closed reduction.

Conclusion

In these severe cases of periprosthetic fracture, the technique reviewed here proved to be reliable.

Mulay S, Hassan T, Birtwistle S, Power R (2005) Management of types B2 and B3 femoral periprosthetic fractures by a tapered, fluted, and distally fixed stem. J Arthroplasty 20(6):751–756PubMedCrossRef

Duncan CP, Masri BA (1995) Fractures of the femur after hip replacement. In: Jackson DW (ed) Instructional Course Lectures 44. Rosemont (Ill), American Academy of Orthopaedic Surgeons, pp 293–300

Adolpson P, Jonsson U, Kalen R (1987) Fractures of the ipsilateral femur after total hip arthroplasty. Arch Orthop Trauma Surg 106:353–357CrossRef

Beals RK, Tower SS (1996) Periprosthetic fractures of the femur: an analysis of 93 fractures. Clin Orthop 327:238–244PubMedCrossRef

Bethea JS III, DeAndrade JR, Fleming LL et al (1982) Proximal femoral fractures following total hip arthroplasty. Clin Orthop 170:95–100PubMed

Dysart SH, Savory CG, Callaghan JJ (1989) Non-operative treatment of a post-operative fracture around an uncemented porous-coated femoral component. J Arthroplas 4:187–192CrossRef

Johansson JE, McBroom R, Barrington TW et al (1981) Fractures of the ipsilateral femur in patients with total hip replacement. J Bone Joint Surg 63A:1435–1441

Lewallen DG, Berry DJ (1998) Periprosthetic fractures of the femur after total hip arthroplasty: treatment and results to date. Instructional Course Lectures. Am Acad Orthop Surg 47:243–255

Missakian ML, Rand JA (1993) Fractures of the femoral shaft adjacent to long stem femoral components of total hip arthroplasty: report of seven cases. Orthop 16:149–155

10.

Mont MA, Maar DC (1994) Fractures of the ipsilateral femur after hip arthroplasty: a statistical analysis of outcome based on 487 patients. J Arthroplast 9:511–516CrossRef

11.

Serocki JH, Chandler RW, Dorr LD (1992) Treatment of fractures about hip prostheses with compression plating. J Arthroplast 7:129–135CrossRef

12.

Kelly SS (1994) Periprosthetic femoral fractures. J Am Acad Orthop Surg 2:164–169

13.

Committee of the Exhibits of the American Academy of Orthopaedic Surgeons. Classification and management of femoral defects in total hip replacements. Committee of the Hip, AAOS Annual Meeting in New Orleans; 1990

14.

Cooke PH, Newman JH (1988) Fractures of the femur in relation to cemented hip prosthesis. J Bone Joint Surg 70B:386–395

15.

Gundolf F (1997) Compression cerclage. In: Huber (ed) 15 years Zweymueller total hip endoprosthesis. Huber Verlag, Bern

16.

Korovessis P, Baikousis A, Stamata B (1998) Arch Orthop Trauma Surg 117:448–452PubMedCrossRef

17.

Park MS, Lim YJ, Chung WC, Ham DH, Lee SH (2009) Management of periprosthetic femur fractures treated with distal fixation using a modular femoral stem using an anterolateral approach. J Arthroplast 8:1270–1276CrossRef

18.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg Am 51A:737–745

19.

Lindahl H, Garellick G, Regnér H, Herberts P, Malchau H (2006) Three hundred and twenty-one periprosthetic femoral fractures. J Bone Joint Surg Am Jun 88(6):1215–1222CrossRef

20.

Garbuz DS, Masri BA, Duncan CP (1998) Periprosthetic fractures of the femur: principles of prevention and management. Instr Course Lect. Am Acad Orthop Surg 47:237–245

21.

Zhao X, Zhu ZA, Sun YH, Wang Y, Zhao J, Zhang YJ, Dai KR (2011) Nickel-titanium shape-memory sawtooth-arm embracing fixator for periprosthetic femoral fractures. Int Orthop Jul 30. doi:10.1007/s00264-011-1325-4

22.

Fink B, Fuerst M, Singer J (2005) Periprosthetic fractures of the femur associated with hip arthroplasty. Arch Orthop Trauma Surg 125(7):433–442PubMedCrossRef

23.

Springer BD, Berry DJ, Lewallen DG (2003) Treatment of periprosthetic femoral fractures following total hip arthroplasty with femoral component revision. J Bone Joint Surg Am 85A:2156–2162

24.

Berry DJ (2003) Treatment of vancouver B3 periprosthetic femur fractures with a fluted tapered stem. Clin Orthop Relat Res 417:224–231PubMed

25.

Kolstad K (1994) Revision THR after periprosthetic femoral fractures. An analysis of 23 cases. Acta Orthop Scand Oct 65(5):505–508CrossRef

26.

Ko PS, Lam JJ, Tio MK, Lee OB, Ip FK (2003) Distal fixation with wagner revision stem in treating vancouver type B2 periprosthetic femur fractures in geriatric patients. J Arthroplast 18(4):446–452CrossRef

27.

Mertl P, Philippot R, Rosset P, Migaud H, Tabutin J, Van de Velde D (2011) Distal locking stem for revision femoral loosening and periprosthetic fractures. Int Orthop 35(2):275–282PubMedCrossRef

28.

Dumez JF, Gayet LE, Avedikian JP et al (1996) Femoral fractures on total hip arthroplasty treated by Charnley’s extra long-stem prosthesis. An 18 cases report. Rev Chir Orthop 82:225–230PubMed

29.

Wroblewski BM, Browne AO, Hodgkinson JP (1992) Treatment of the shaft of the femur in total hip arthroplasty by a combination of a Kuntscher nail and a modified cemented Charnley stem. Injury 23:225–227PubMedCrossRef

30.

Stoffelen DV, Broos PL (1995) The use of the Wagner revision prosthesis in complex (post) traumatic conditions of the hip. Acta Orthop Belg 61:135–140PubMed

31.

Sporer SM, Paprosky WG (2004) Femoral fixation in the face of considerable bone loss. Clin Orthop Relat Res 429:227–231PubMedCrossRef

Title: Management of Vancouver B2 and B3 femoral periprosthetic fractures using a modular cementless stem without allografting
Authors: Daniel Neumann
Christoph Thaler
Ulrich Dorn
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 5/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1371-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of Vancouver B2 and B3 femoral periprosthetic fractures using a modular cementless stem without allografting

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2012

The gait function of slipped capital femoral epiphysis in patients after growth arrest and its correlation with the clinical outcome

What treatment for periprosthetic shoulder infection? Results from a multicentre retrospective series

Distraction osteogenesis using a longitudinal corticotomy

Heat distribution of polymerisation temperature of bone cement on the spinal canal during vertebroplasty

The Bicontact cementless primary total hip arthroplasty: long-term results

Over-expression of Sox2 in C3H10T1/2 cells inhibits osteoblast differentiation through Wnt and MAPK signalling pathways