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Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 1, pp 9–14 | Cite as

Treatment of periprosthetic femur fractures around a well-fixed hip arthroplasty implant: span the whole bone

  • Gele B. Moloney
  • Edward R. Westrick
  • Peter A. Siska
  • Ivan S. TarkinEmail author
Orthopaedic Surgery

Abstract

Introduction

Periprosthetic femur fractures are a growing problem in the geriatric population. This study examines Vancouver B1 periprosthetic femur fractures treated with open reduction internal fixation using a laterally based plate. Outcomes using plates which spanned the length of the femur to the level of the femoral condyles were compared to those which did not. The hypothesis was that spanning internal fixation would result in a decreased rate of refracture and subsequent reoperation.

Materials and methods

Patients admitted to three affiliated academic hospitals treated with open reduction internal fixation for a periprosthetic femur fracture in the setting of a preexisting total hip arthroplasty or hemiarthroplasty stem were identified. Patient data were reviewed for age, gender, fracture classification, operative intervention, time to union, as well as complications related to treatment and need for further surgery.

Results

Over a 5-year period, 58 patients were treated with open reduction internal fixation using a laterally based plate for Vancouver B1 femur fractures. Twenty-one patients were treated with plates that extended to the level of the femoral condyles. In that group there were no nonunions or subsequent periprosthetic fractures reported. Of 36 patients treated with short plates, 3 went on to nonunion resulting in plate failure and refracture and 2 sustained a subsequent fracture distal to the existing fixation.

Conclusions

In this series, fixation for periprosthetic femur fractures around a well-fixed arthroplasty stem which spans the length of the femur to the level of the femoral condyles is associated with a decreased rate of nonunion and refracture. By decreasing the rate of refracture and nonunion, spanning fixation decreases the morbidity and mortality associated with additional surgery in a fragile geriatric population.

Keywords

Geriatric hip fracture Periprosthetic femur fracture 

Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Gele B. Moloney
    • 1
  • Edward R. Westrick
    • 1
  • Peter A. Siska
    • 1
  • Ivan S. Tarkin
    • 1
    Email author
  1. 1.Division of Orthopaedic Trauma, Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA

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