Management of type B2 and B3 post-operative proximal periprosthetic femoral fractures, Oghara experience

Objective: To report the outcome of treatment of Types B2 and B3 Post- operative Periprosthetic proximal femoral fracture (PPFF) in four patients treated in Delta State University Teaching Hospital, Oghara, Delta State, using Vancouver classification of Duncan and Masri. Methodology: A retrospective study of four cases managed in this hospital. Information retrieved from case notes were sex, age, duration of prosthesis, treatment given, complications and outcome of treatment. Result: Atotal of 4 patients were reviewed in the study, 2 males and 2 females with a M: F of 1: 1. Duration of the implant before treatment was 5-12 years (mean of 8.3years). Age range was 60-83years (mean of 67.5 years). Two patients had Type B2 and two had Type B3. Average intraoperative blood loss was 1 litre. Duration of surgery was 3-4 hours. Duration of hospital stay was between 3 weeks and 5 months. The complications seen were primary haemorrhage, wound infection, hip dislocation and pulmonaryembolism. The outcome was good for 3 patients and fair in 1, using Harris Hip Score. Conclusion:Vancouver classification of Duncan and Masri is effective in the treatment of PPFF. Key words; Periprosthetic femoral fracture, Long stem hip prosthesis, Vancouver classification, osteolysis.

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Use of a long distally fixed intramedullary stem to treat a periprosthetic femoral fracture following total hip arthroplasty using a thrust plate hip prosthesis: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2017.06.010 ◽

2017 ◽

Vol 37 ◽

pp. 65-68

Author(s):

Hiroyuki Hatanaka ◽

Goro Motomura ◽

Satoshi Ikemura ◽

Kazuhiko Sonoda ◽

Yusuke Kubo ◽

...

Keyword(s):

Case Report ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Femoral Fracture ◽

Hip Prosthesis ◽

Periprosthetic Femoral Fracture ◽

Total Hip

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Periprosthetic femoral fracture type and location are influenced by the presence of an ipsilateral knee arthroplasty implant: A case-control study of 84 interprosthetic femoral fractures

Injury ◽

10.1016/j.injury.2021.11.047 ◽

2021 ◽

Author(s):

Oliver Townsend ◽

Sameer Jain ◽

Jonathan N Lamb ◽

Chloe E H Scott ◽

Douglas G Dunlop ◽

...

Keyword(s):

Knee Arthroplasty ◽

Femoral Fracture ◽

Case Control Study ◽

Femoral Fractures ◽

Case Control ◽

Periprosthetic Femoral Fracture ◽

Fracture Type ◽

Control Study

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Atypical periprosthetic femoral fracture associated with long-term bisphosphonate therapy

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01941-x ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Dávid Dózsai ◽

Tamás Ecseri ◽

István Csonka ◽

István Gárgyán ◽

Péter Doró ◽

...

Keyword(s):

Femoral Fracture ◽

Case Reports ◽

Femoral Stem ◽

Femoral Fractures ◽

Atypical Femoral Fracture ◽

Periprosthetic Fractures ◽

Periprosthetic Femoral Fracture ◽

Mineral Research ◽

Periprosthetic Femoral Fractures

Abstract Background Atypical femoral fracture is one of the many complications after the long-term use of bisphosphonates. The American Society for Bone and Mineral Research has officially excluded periprosthetic femoral fractures (PFFs) from the definition of atypical femoral fractures (AFFs). Several case reports found that PFFs can occur with characteristics similar to those of AFFs. The purpose of our study was to evaluate the proportion of atypical fractures among Vancouver type B1 fractures, and to determine the association between the long-term use of bisphosphonates and the occurrence of atypical periprosthetic femoral fractures (APFFs). Methods In this retrospective study, we reviewed 41 patients with Vancouver type B1 periprosthetic fractures between January 1, 2011 and December 31, 2018. We classified them into two groups, namely atypical and typical PFFs, based on the fracture morphology. We noted the proportion of atypical periprosthetic fractures among B1 fractures and identified risk factors. Results Among the 41 PFFs, 5 (13%) fractures were classified as atypical PFF based on the radiological characteristics. The longer duration of bisphosphonate use was probably the only independent risk factor that significantly increases the occurrence of APFF (p = 0.03, 0.08 (CI 0.008 – 0.16)). There were no significant differences in age, gender, body mass index, comorbidities, corticosteroid use, positioning of the femoral stem, the method of fixation (cemented or cementless) and time lapse from before the primary prosthesis implantation to the PFF in the development of atypical fracture type. Conclusions There seems to be a correlation between the long-term intake of bisphosphonates and the atypical periprosthetic fracture. Atypical femoral fracture can also occur in the periprosthetic form. Trial registration Study number: 22/2019-SZTE, http://www.klinikaikutatas.hu/hu/kutatasetika/jovahagyott-vizsgalatok-koezerdeku-adatai/category/25-jovahagyott-vizsgalatok-kozerdeku-adatai-rkeb-2019.html?download=985:22-2019.

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Treatment of Periprosthetic Femoral Fracture according to the Vancouver Classification

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2007.42.2.147 ◽

2007 ◽

Vol 42 (2) ◽

pp. 147

Author(s):

Il-Yong Choi ◽

Duk-Moon Jung ◽

Seoung-Pyo Seo ◽

Young-Ho Kim

Keyword(s):

Femoral Fracture ◽

Periprosthetic Femoral Fracture ◽

Vancouver Classification

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Short uncemented femoral component for hip revision: prognosis and risk factors associated with failure

BMC Surgery ◽

10.1186/s12893-021-01196-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zeming Liu ◽

Bo Liu ◽

Bingshi Zhang ◽

Wenhui Ma ◽

Tao Wu ◽

...

Keyword(s):

Risk Factors ◽

Survival Rate ◽

Femoral Component ◽

Revision Surgery ◽

Femoral Fracture ◽

Femoral Stem ◽

Harris Hip Score ◽

Categorical Variables ◽

Periprosthetic Femoral Fracture ◽

Significant Difference

Abstract Background The application of short femoral stems is partially restricted in revision surgery. This study will demonstrate the therapeutic effect and unsuitable situation for short stem revision. Methods Demographic characteristics of all patients were recorded in detail (Table 1). Anteroposterior view radiographic examinations of proximal femur are necessary before and after the operation for patients. The primary outcome of interest was the survival rate of the femoral stem at the final follow-up. Risk factors for failure were also investigated. The secondary outcomes of interest included the Harris hip score, excellent to good rate and incidence of complications. The Mann–Whitney U test was performed for comparisons between continuous variables. The chi-square test was performed for comparisons between categorical variables. Cox regression analysis was used to assess the association between potential risk factors and the failure of revision surgery. Results A total of 381 patients with short stems were retrospectively reviewed. There were 188 males and 193 females. The average age and body mass index before revision surgery were 58.85 ± 13.46 years and 23.72 ± 3.40 kg/m2, respectively. The mid-term survival rate of the short femoral component was 94.23%. The prognosis and complications of patients between the two groups were compared. There was no significant difference between the two groups in the Harris score, complication incidence or survival rate of the femoral component. The strongest risk factor in this study was intraoperative periprosthetic femoral fracture during revision surgery (HR = 5.477, 95% CI = 2.156–13.913). Conclusion Three risk factors for failure were identified: ageing, osteoporosis and intraoperative periprosthetic femoral fracture during revision surgery. Therefore, a short femoral stem should be implanted in patients with these risk factors with additional caution.

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The impact of stem fixation method on Vancouver Type B1 periprosthetic femoral fracture management

SICOT-J ◽

10.1051/sicotj/2021064 ◽

2022 ◽

Vol 8 ◽

pp. 1

Author(s):

Katherine Wang ◽

Eustathios Kenanidis ◽

Zakareya Gamie ◽

Khurram Suleman ◽

Mark Miodownik ◽

...

Keyword(s):

Strain Distribution ◽

Hip Prosthesis ◽

Mechanical Strain ◽

Femoral Fractures ◽

Fixation Method ◽

Periprosthetic Femoral Fracture ◽

Periprosthetic Femoral Fractures ◽

Fracture Management ◽

The Impact ◽

Laboratory Models

Introduction: Our understanding of the impact of the stem fixation method in total hip arthroplasty (THA) on the subsequent management of periprosthetic femoral fractures (PFF) is still limited. This study aimed to investigate and quantify the effect of the stem fixation method, i.e., cemented vs. uncemented THA, on the management of Vancouver Type B1 periprosthetic femoral fractures with the same plate. Methods: Eight laboratory models of synthetic femora were divided into two groups and implanted with either a cemented or uncemented hip prosthesis. The overall stiffness and strain distribution were measured under an anatomical one-legged stance. All eight specimens underwent an osteotomy to simulate Vancouver type B1 PFF’s. Fractures were then fixed using the same extramedullary plate and screws. The same measurements and fracture movement were taken under the same loading conditions. Results: Highlighted that the uncemented THA and PFF fixation constructs had a lower overall stiffness. Subsequently, the mechanical strain on the fracture plate for the uncemented construct was higher compared to the cemented constructs. Conclusion: PFF fixation of a Vancouver type B1 fracture using a plate may have a higher risk of failure in uncemented THAs.

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Traumatic obturator–anterior type dislocation of the hip with an ipsilateral ischial tuberosity and greater trochanter fractures: Case report

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491720978985 ◽

2020 ◽

pp. 221049172097898

Author(s):

Juan Manuel Concha ◽

Humberto Gonzalez ◽

Andrea C Montero ◽

Nelsy B Mueses ◽

Heydy Y Muñoz ◽

...

Keyword(s):

Hip Dislocation ◽

Femoral Fractures ◽

High Energy ◽

Ischial Tuberosity ◽

Harris Hip Score ◽

Acetabular Fractures ◽

Functional Evaluation ◽

Greater Trochanter ◽

Anterior Hip Dislocation ◽

Trochanter Fracture

Anterior hip dislocation is a rare orthopedic emergency, usually following high-energy trauma. This injury is occasionally associated with acetabular fractures, femoral head fractures, or diaphyseal femoral fractures. However, the combination between the anterior hip dislocation and the ipsilateral ischial tuberosity and greater trochanter fractures is extremely rare, and very sparsely reported in the literature. This paper reports a case of an obturator type of anterior hip dislocation associated with a concomitant ipsilateral ischial tuberosity and greater trochanter fracture. The hip dislocation was reduced by closed means under general anesthesia, and the greater trochanter fracture was reduced and internally fixed with tension band in a second stage. Radiological and functional evaluation at 12 months after surgery, using the Harris Hip Score (HHS), was good.

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Clinical outcomes in the treatment of femoral fracture by using intramedullary femur nailing system

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211399 ◽

2021 ◽

Author(s):

Shashank Mishra ◽

Mohit Kumar ◽

Prashant Kumar ◽

Gaurav Luthra

Keyword(s):

Clinical Outcomes ◽

Femoral Fracture ◽

Femoral Fractures ◽

Ao Classification ◽

Femoral Nailing ◽

Femoral Nail ◽

American Society ◽

Hospital Group

Background: Femoral fractures are frequently occurring fractures that are caused due to large force impaction. The purpose of this study was to clinically evaluate the outcomes of treating femoral fractures with the use of the intramedullary femoral nailing system.Methods: This retrospective clinical trial consists of 32 patients with femoral fracture and are treated by using an intramedullary femoral nailing system which consists of retrograde femoral nail, gamma nails, expert femoral nail, universal intramedullary cannulated femoral nails that are manufactured by Auxein medical Pvt. Ltd. Sonipat, Haryana, India. There were 32 patients from two different hospitals i.e., first hospital group consist of 15 patients (8 male and 7 female) with mean age of 32 years and the second hospital group consist of 17 patients (9 male and 8 female). The fracture categorization was done on the basis of AO Classification of fracture and physical fitness was categorized by American society of anaesthesiologists. VAS score and HHS was used as a criterion for assessing the clinical outcomes of the patients.Results: There were 32 patients to whom surgery was performed and follow up time was 1 month, 3 months, 6 months and 12 months. After the final follow up no patient in any group complaint about the complications or any hardware related problem, there were perfect bone union in every patient. Radiological outcomes also showed proper union at 6 months follow up.Conclusions: For femoral fractures, intramedullary femoral nail gives a better result with high union rate and post-operative composure.

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