Abstract

GARABANO, Germán et al. Tratamiento de las fracturas periprotésicas de fémur Vancouver B2 y B3. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2012, vol.77, n.4, pp.252-259. ISSN 1852-7434.

Background: Periprosthetic fractures of the femur are becoming more prevalent. When this fracture occurs in a loose stem (B2) or with bone loss (B3), the treatment is femoral stem revision. Methods: We analyzed retrospectively 22 patients, 9 with type B2 fractures and 13 with type B3 fractures of the Vancouver classification. Follow-up averaged 48 months. We used cemented long stems, with impacted bone allograft, strut allograft, uncemented long stems (with distal fixation) and unconventional endoprosthesis according to the case. Results: All fractures healed and remodeled. The complications were 2 (9%) dislocations, 1 (4.5%) infection, 1 (4.5%) calcar fracture, 1 (4.5%) loosening of cemented acetabular component and 2 (9%) deaths. Conclusions: The periprosthetic femoral fractures B2 and B3 require replacement of the femoral stem, while there is a trend to use uncemented stems; in this series due to the overlap of treatments according to each subtype of fracture, there were no differences between the use of cemented stems with allograft or uncemented stem. In cases of severe bone loss the unconventional endoprosthesis offer a treatment option for patients with low functional demand. The Vancouver classification is a useful tool to guide the surgeon on the treatment.

Keywords : Hip periprosthetic fracture; Cemented long-stem; Cementless long-stem; Hip revision.

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