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Surgical treatment of Vancouver type B periprosthetic femoral fractures PATIENT CHARACTERISTICS AND OUTCOMES OF 1381 FRACTURES TREATED IN SWEDEN BETWEEN 2001 AND 2011

Artikel i vetenskaplig tidskrift
Författare Georgios Chatziagorou
H. Lindahl
Johan Kärrholm
Publicerad i Bone & Joint Journal
Volym 101B
Nummer/häfte 11
Sidor 1447-1458
ISSN 2049-4394
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 1447-1458
Språk en
Länkar doi.org/10.1302/0301-620X.101B11.BJ...
Ämnesord total hip-arthroplasty, femur fractures, plate fixation, revision, classification
Ämneskategorier Ortopedi

Sammanfattning

Aims We investigated patient characteristics and outcomes of Vancouver type B periprosthetic fractures treated with femoral component revision and/or osteosynthesis. Patients and Methods The study utilized data from the Swedish Hip Arthroplasty Register (SHAR) and information from patient records. We included all primary total hip arthroplasties (THAs) performed in Sweden since 1979, and undergoing further surgery due to Vancouver type B periprosthetic femoral fracture between 2001 and 2011. The primary outcome measure was any further reoperation between 2001 and 2013. Cross-referencing with the National Patient Register was performed in two stages, in order to identify all surgical procedures not recorded on the SHAR. Results Out of 1381 Vancouver type B fractures that fulfilled the inclusion criteria, 257 underwent further reoperation by the end of 2013. Interprosthetic and Type B1 fractures had a higher risk for reoperation. For B1 fractures, the rate of reoperation did not differ (p = 0.322) after use of conventional (26%) or locking plate osteosynthesis (19%). No significant differences were observed between cemented, cementless monoblock, and cementless modular revision components for the treatment of type B2 and B3 fractures. Conclusion In this country-specific study, the choice of locking or conventional plates for the treatment of type B1, and cemented or cementless femoral components fixation for B2 and B3 fractures, had no significant influence on risk for reoperation. Interprosthetic fractures adversely affected the outcome of treatment of type B fractures. Differences in the patient characteristics of the compared groups were observed.

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