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European Journal of Orthopaedic Surgery & Traumatology

Published in:

25-03-2024 | Original Article

Vancouver B2 periprosthetic hip fractures treatment: fix or replace? A retrospective study comparing both techniques

Authors: Yuri Lara-Taranchenko, Josep F. Nomdedéu Jr., Víctor M. Barro, José V. Andrés Peiró, Ernesto Guerra-Farfán, Jordi Selga, Jordi Tomás-Hernández, Jordi Teixidor Serra, Vicente Molero, Diego Collado, Iñaki Mimendia, Alejandro Hernández, Juan A. Porcel-Vázquez

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2024

Abstract

Introduction

Vancouver B2 periprosthetic hip fractures involve stem stability and they have been classically treated with revision surgery. Crucial factors such as age, clinical comorbidities and functional status are often neglected. The current study aims to compare clinical outcomes between patients treated with open reduction and internal fixation (ORIF) or femoral stem exchange.

Methods

This is a retrospective study that includes all Vancouver B2 periprosthetic hip fractures in a tertiary referral hospital from 2016 to 2020. Patients were divided into two groups: Group 1. Patients treated with an ORIF and Group 2. Patients treated with stem replacement. The outcomes that were compared between groups included demographic data, functional capacity, complications and mortality.

Results

29 periprosthetic Vancouver B2 fractures were finally analyzed. 11 (37.9%) were treated with ORIF (Group 1) and 18 (62.1%) by stem replacement (Group 2). Surgery time (143 vs. 160 min), hemoglobin drop (1.8 vs. 2.5 g/dL) and hospital stance (25.5 vs. 29.6 days) were shorter in Group 1. According to complications, 18.2% of patients in the ORIF group had orthopedic complications compared with 44.4% in the revision group. In the revision group, 3 cases needed a two-stage revision and one of these revisions ended up with a resection arthroplasty (Girdlestone). The first-year mortality rate was 27% in Group 1 and 11% in Group 2.

Discussion

ORIF treatment seems to be a less aggressive and complex procedure which can lead to a faster general recovery. Revision surgery can imply a higher risk of orthopedic complications which can be severe and may require further aggressive solutions. The ORIF group mortality was similar to the proximal femur fracture rate (20–30%). In conclusion, ORIF treatment seems to be a good option especially in fragile patients with low functional demand when anatomical reduction is possible.

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Title: Vancouver B2 periprosthetic hip fractures treatment: fix or replace? A retrospective study comparing both techniques
Authors: Yuri Lara-Taranchenko
Josep F. Nomdedéu Jr.
Víctor M. Barro
José V. Andrés Peiró
Ernesto Guerra-Farfán
Jordi Selga
Jordi Tomás-Hernández
Jordi Teixidor Serra
Vicente Molero
Diego Collado
Iñaki Mimendia
Alejandro Hernández
Juan A. Porcel-Vázquez
Publication date: 25-03-2024
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03881-2

2024 ASCO Annual Meeting

Springer Medicine

Vancouver B2 periprosthetic hip fractures treatment: fix or replace? A retrospective study comparing both techniques

Abstract

Introduction

Methods

Results

Discussion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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