Open reduction and internal fixation might be a valuable alternative to stem revision in Vancouver B2 periprosthetic femoral fractures, irrespective of the stem's design.
ORIF
Periprosthetic fractures
Stem revision
Vancouver B2
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
20
03
2020
accepted:
02
08
2020
pubmed:
12
8
2020
medline:
29
6
2021
entrez:
12
8
2020
Statut:
ppublish
Résumé
The purpose of this study was to compare the clinical and radiological outcomes following open reduction and internal fixation (ORIF) of Vancouver B2 periprosthetic femoral fractures versus stem revision (SR) surgery. Between 2004 and 2018, 39 patients were treated with SR and 31 with ORIF for a Vancouver type B2. Mean follow-up was 40.4 months for the ORIF group and 43.5 months for the SR group. 22 of 31 stems in the ORIF group were uncemented, of which 7 (23%) were short stems. Perioperative complications, intraoperative blood loss, revision rate, and mortality were recorded. Functional outcomes included Harris Hip Score, Parker Mobility Score and hip abductor strength. Both groups did not differ in the American Society of Anesthesiologists (ASA) score, Charlson comorbidity index, body mass index, age, and sex. Compared to SR, patients treated with ORIF had a decreased blood loss, transfusion rate, operation duration, and mortality. Total complication and re-operation rates were similar. The relative risk for complication and re-operation was 0.5 and 0.7, respectively, in favour of ORIF. ORIF might be a valuable alternative to SR in the treatment of Vancouver type B2 periprosthetic fractures with shorter operation duration, lower blood loss and similar complication rate compared to SR. Moreover, re-stabilization seems possible irrespective of stem's design or fixation technique. Level III.
Sections du résumé
BACKGROUND
BACKGROUND
The purpose of this study was to compare the clinical and radiological outcomes following open reduction and internal fixation (ORIF) of Vancouver B2 periprosthetic femoral fractures versus stem revision (SR) surgery.
METHODS
METHODS
Between 2004 and 2018, 39 patients were treated with SR and 31 with ORIF for a Vancouver type B2. Mean follow-up was 40.4 months for the ORIF group and 43.5 months for the SR group. 22 of 31 stems in the ORIF group were uncemented, of which 7 (23%) were short stems. Perioperative complications, intraoperative blood loss, revision rate, and mortality were recorded. Functional outcomes included Harris Hip Score, Parker Mobility Score and hip abductor strength.
RESULTS
RESULTS
Both groups did not differ in the American Society of Anesthesiologists (ASA) score, Charlson comorbidity index, body mass index, age, and sex. Compared to SR, patients treated with ORIF had a decreased blood loss, transfusion rate, operation duration, and mortality. Total complication and re-operation rates were similar. The relative risk for complication and re-operation was 0.5 and 0.7, respectively, in favour of ORIF.
CONCLUSIONS
CONCLUSIONS
ORIF might be a valuable alternative to SR in the treatment of Vancouver type B2 periprosthetic fractures with shorter operation duration, lower blood loss and similar complication rate compared to SR. Moreover, re-stabilization seems possible irrespective of stem's design or fixation technique.
LEVEL OF EVIDENCE
METHODS
Level III.
Identifiants
pubmed: 32778919
doi: 10.1007/s00402-020-03568-3
pii: 10.1007/s00402-020-03568-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
871-878Références
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