Mid- and long-term efficacy of surgical treatment of Vancouver B2 and B3 periprosthetic femoral fractures

BMC Surgery

Yu Zhang¹  Ye Zhang¹  Xiang-Yang Chen¹  Jian-Ning Sun¹  Shuo Feng¹  Jia-Ming Zhang² 

[1] Department of Orthopedic Surgery, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai Road, 221002, Xuzhou, Jiangsu, China;Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050000, Shijiazhuang, Hebei, China;

关键词: Vancouver B2/B3;    Periprosthetic femoral fractures;    Hip arthroplasty;   

DOI  :  10.1186/s12893-020-00891-9

来源: Springer

【 摘 要 】

BackgroundThe incidence of fractures around the femoral prosthesis among patients undergoing hip arthroplasty is increasing and has become the third leading cause of hip revision. While numerous methods for the surgical treatment of periprosthetic femoral fractures (PFFs) have been proposed, only few reports have examined the long-term efficacy of surgical treatment. This study aims to examine the mid-and long-term efficacy of surgical treatment among patients with Vancouver B2 and B3 PFFs.MethodsThis retrospective study evaluated the surgical outcomes of patients with Vancouver B2 and B3 PFFs between 2007 and 2011. The minimum follow-up time was eight years. Fracture healing, prosthesis stability, complications, patient quality of life SF-36 score, and survival rate were evaluated during the follow-up assessments.ResultsA total of 83 patients were included and had an average follow-up period of 120.3 months. Among these patients, 69 were classified as Vancouver B2 and were treated with a distal fixation stem, whereas 14 cases were classified as Vancouver B3 and were treated with modular femoral prosthesis by using a proximal femoral allograft technique. A total of 15 patients underwent secondary revision surgery, and prosthesis dislocation was identified as the main cause of secondary revision. 80 (96.4%) cases of fractures were clinically healed. The mortality rate in the first year after surgery was 8.4% (7/83). The overall 5-year Kaplan–Meier survival rate for these patients was 75.9%. Meanwhile, the 5-year Kaplan–Meier survival rate for the implants was 86.9%. The final follow-up SF-36 score of the patients was 48.3 ± 9.8.ConclusionsPatients with Vancouver B2 and B3 PFFs show high mortality in the first year after their surgery, and the Kaplan–Meier analysis results showed that such mortality tends to plateau after 5 years. Prosthesis dislocation was identified as the primary cause of secondary revision.

【 授权许可】

CC BY