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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2011, Number 5

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Acta Ortop Mex 2011; 25 (5)

Periprosthetic femur fractures. Experience at Hospital Español de México with a 2-year follow-up

Suárez-Ahedo CE, Obil-Chavarría CA, Gil-Orbezo FI, Valles-Figueroa JF, García-Félix Díaz G, Antúnez-García M
Full text How to cite this article

Language: Spanish
References: 11
Page: 273-275
PDF size: 35.86 Kb.


Key words:

fracture, femur, treatment, fixation, graft.

ABSTRACT

Periprosthetic fractures have had an increasing incidence in the past decades; their resolution is a difficult challenge even for the most experienced orthopedist surgeons. The Vancouver classification has contributed to a great extent to their better characterization and therapeutic guidance. The purpose of this paper is to make a review of the most recent advances on the topic and present our experience in the treatment of these fractures. Material and methods: We describe the characteristics of a sample of 20 patients with periprosthetic femur fractures treated at our hospital from March 2008 to March 2010 and typed according to the Vancouver classification. Results: Mean age was 74.5 years with a range of 65-87 years. Females were predominant (70%). Five cases were type A in the classification, 10 cases type B, and 5 cases type C. Nineteen underwent surgical treatment. The mean total length of stay was 7 days, with a range of 5-12. The mean healing time for types B and C was 4 months (range 3–6 months). Four patients had complications. The resolution was assessed as excellent in 5 cases (25%), good in 11 cases (55%), and poor in 4 cases (20%). Conclusions: A thorough individual assessment based on the Vancouver classification, age and the patient’s functional requirements are the major parameters for treatment success.


REFERENCES

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  2. Holley K, Zelken J, Padgett D, Chimento G, Yun A, Buly R: Periprosthetic fractures of the femur after hip arthroplasty: An analysis of 99 patients. HSSJ 2007;3:190-7.

  3. Berry DJ: Management of periprosthetic fractures: the hip. J Arthroplasty 2002;17(4 Suppl 1):11-3.

  4. Duncan CP, Masri BA: Fractures of the femur after hip replacement. Instr Course Lect 1995;45:293-304.

  5. Masri B, Dominic Meek RM, Duncan CP: Periprosthetic fractures. Evaluation and treatment. Clin Otrhop 2004;420:80-95.

  6. Sledge JB, Abiri A: An algorithm for the treatment of Vancouver type B2 periprosthetic proximal femoral fractures. J Arthroplasty 2002;17:887-92.

  7. Berry DJ: Treatment of Vancouver B3 periprosthetic femur fractures with a fluted tapered stem. Clin Orthop 2003;417:224-31.

  8. Clift B: Periprosthetic fracture of the femur. J Bone Joint Surg Am 2000;82(3):446-7.

  9. Haddad FS, Duncan CP, Berry DJ, Lewallen DG, Gross AE, Hugh P: Chandler periprosthetic femoral fractures around well-fixed implants: Use of cortical onlay allografts with or without a plate. J Bone Joint Surg Am 2002;84:945-50.

  10. Wang JW, Wang CJ: Periprosthetic fracture of the femur after hip arthroplasty: The clinical outcome using cortical strut allografts. Journal of Orthopaedic Surgery 2000;8(1):27-31.

  11. Brady OH, Garbuz DS, Masri BA, Duncan CP: The treatment of periprosthetic fractures of the femur using cortical onlay allograft struts. Orthop Clin North Am 2000;30(2):215-20.




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