دورية أكاديمية
أعرض في EDS

Do All Postoperative Vancouver B2 Fractures Require Revision Arthroplasty With Cementless Stems?

التفاصيل البيبلوغرافية
العنوان: Do All Postoperative Vancouver B2 Fractures Require Revision Arthroplasty With Cementless Stems?
المؤلفون: Wilke BK; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL., Spaulding AC; Department of Biostatistics, Mayo Clinic, Jacksonville, FL., Crowe MM; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL., Ledford CK; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL., Sherman CE; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL., Spencer-Gardner L; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL., Blasser KE; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL.
المصدر: Arthroplasty today [Arthroplast Today] 2024 Jun 14; Vol. 28, pp. 101444. Date of Electronic Publication: 2024 Jun 14 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101681808 Publication Model: eCollection Cited Medium: Print ISSN: 2352-3441 (Print) Linking ISSN: 23523441 NLM ISO Abbreviation: Arthroplast Today Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Maryland Heights, MO] : Elsevier, [2015]-
مستخلص: Background: Management of periprosthetic fractures has been guided by the Vancouver classification, which recommends revision for fractures around a loose femoral implant (B2). New studies have challenged this approach, demonstrating acceptable outcomes with internal fixation. This study evaluates our experience with Vancouver B2 fractures, comparing internal fixation to femoral revision. We hypothesized that in select cases with cementless stems, internal fixation would provide acceptable results with reduced morbidity.
Methods: A retrospective review was performed of periprosthetic hip fractures treated at our institution between 1 January 2012 and 4 November 2022. We excluded patients who did not have prior radiographs and evidence of stem subsidence, suggestive of a Vancouver B2 fracture. Thirteen patients were included in the analysis.
Results: Four patients (31%) underwent revision of the femoral component, 4 patients (31%) underwent plating, and 5 patients (38%) underwent internal fixation with cerclage cabling. The average operative duration was 158 minutes, 203 minutes, and 62 minutes for the revision, plating, and cabling cohorts, respectively ( P  = .009). Blood loss was 463 cc, 510 cc, and 90 cc for the revision, plating, and cabling cohorts, respectively ( P  = .036). Three patients in both the revision and plating cohorts each received a transfusion (75%), whereas no patients in the cabling cohort required a transfusion ( P  = .033). All patients demonstrated fracture healing on the postoperative radiographs. No patients required additional surgery during the follow-up period.
Conclusions: We have demonstrated that Vancouver B2 periprosthetic fractures with intact lateral cortices may be treated with internal fixation with cerclage cabling with excellent results.
(© 2024 The Authors.)
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فهرسة مساهمة: Keywords: Hip fracture; Periprosthetic fracture; Revision; Vancouver classification
تواريخ الأحداث: Date Created: 20240708 Latest Revision: 20240709
رمز التحديث: 20240709
مُعرف محوري في PubMed: PMC11225803
DOI: 10.1016/j.artd.2024.101444
PMID: 38974717
قاعدة البيانات: MEDLINE
الوصف
تدمد:2352-3441
DOI:10.1016/j.artd.2024.101444