Abstract

DIAZ DILERNIA, Fernando; ONATIVIA, José I.; SLULLITEL, Pablo  and  BUTTARO, Martín. Tratamiento de las fracturas femorales periprotésicas Vancouver B3 con injerto óseo impactado. Supervivencia y complicaciones. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.6, pp.737-746. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.6.1280.

Aims: Because the gold standard for the treatment of Vancouver type B3 periprosthetic femoral fractures (PFFs) is yet to be defined, we sought to analyze the complication rate of the impaction bone grafting (IBG) technique with a cemented stem for the treatment of this fractures. Materials and Methods: We retrospectively studied 33 B3 PFFs treated with the IBG technique operated between 2000 and 2016, analyzing the complication rate. The median follow-up was 75 months (interquartile range [IQR], 36-111). The median age was 78 years (IQR, 74-83). The median grade of EndoKlinik femoral bone defect was 3 (IQR, 3-3). We performed a multiple regression analysis to determine risk factors for complications, including the following variables: number of previous surgeries, femoral head diameter, and femoral bone defect. Results: As for infection outcomes, 2-stage revision surgery was performed in 4 patients. We registered 5 implant failures and 2 dislocations in the whole series. Multiple regression analysis showed a significant association between the grade of EndoKlinik femoral bone defect and complication rate (P=0.04). Conclusion: Femoral reconstruction with the IBG technique evidenced a high complication rate for the treatment of B3 PFF.

Keywords : B3 periprosthetic femoral fractures; impaction bone grafting technique; complications; survivorship analysis.

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