Abstract

AGUIRRE, Gerardo L. et al. Osteosíntesis en fracturas femorales periprotésicas de cadera Vancouver tipos B1 y C. Análisis multicéntrico. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.5, pp.652-659. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.5.1601.

Introduction: Our objective was to analyze the results of osteosynthesis treatment in patients with Vancouver type B1 and C fractures, evaluate complications, reinterventions and the mortality rate in this group. Materials and Methods: Multicenter, retrospective study. A database was established that included 53 patients with Vancouver type B1 and C periprosthetic femoral fractures treated with osteosynthesis, from 2008 to 2021, who were evaluated in two high-complexity hospital centers. Results: The most used proximal fixation was bicortical screws and wire loops. The type of fracture according to the Vancouver classification correlated with a significant value in the use of interfragmentary compression screws (p 0.001), with a total of 13 patients (24.52%), 9 in Vancouver type C fractures. Mean consolidation was 4 months, with a mean Harris Hip Score of 68. Twelve patients (22.64%) had complications: delayed union (7 cases; 13.2%), failed osteosynthesis with fracture at the distal level of the stem (one case; 1.88%), one new osteosynthesis due to failure at the level of the osteosynthesis material (one case; 1.88%) and three patients died (5.66%). Conclusions: The management of periprosthetic femoral fractures is a complex and challenging issue. Osteosynthesis treatment is a successful method that requires the application of current principles of minimally invasive techniques that, together with stable proximal fixation, improve the chances of success.

Keywords : Periprosthetic femoral fractures; osteosynthesis; Vancouver classification.

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