Skip to main content

Advertisement

Log in

The inverted Vancouver C fracture. Case series of unstable proximal femur fractures above a knee revision stem treated by short cephalomedullary nail and lateral submuscular overlapping plate

  • Technical Note
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

A Correction to this article was published on 16 August 2021

This article has been updated

Abstract

Unstable proximal femur fractures above a knee revision stem are an emerging complication that is especially difficult to treat. Since this pattern does not adapt to any previously reported classification, we named it “inverted Vancouver C fracture”. In this single-centre case series, we pose a nail–plate combination for the treatment of such clinical picture. The incidence was low among proximal and implant-related femoral fractures. All the fractures healed without records of major local complications. Thus, we consider this technique safe and reproducible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Change history

References

  1. Meek RMD, Norwood T, Smith R, Brenkel IJ, Howie CR (2011) The risk of peri-prosthetic fracture after primary and revision total hip and knee replacement. J Bone Joint Surg Br 93B(1):96–101

    Article  Google Scholar 

  2. Parvizi J, Jain N, Schmidt AH (2008) Periprosthetic knee fractures. J Orthop Trauma 22(9):663–671

    Article  Google Scholar 

  3. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF (2018) Fracture and dislocation classification compendium-2018. J Orthop Trauma 32(Suppl 1):S1–S170

    Article  Google Scholar 

  4. Rizkalla JM, Nimmons SJB, Jones AL (2019) Classifications in brief: the Russell-Taylor classification of subtrochanteric hip fracture. Clin Orthop 477(1):257–261

    Article  Google Scholar 

  5. Seinsheimer F (1978) Subtrochanteric fractures of the femur. J Bone Joint Surg Am 60(3):300–306

    Article  CAS  Google Scholar 

  6. Mayhew D, Mendonca V, Murthy BVS (2019) A review of ASA physical status—historical perspectives and modern developments. Anaesthesia 74(3):373–379

    Article  CAS  Google Scholar 

  7. McPherson EJ, Woodson C, Holtom P, Roidis N, Shufelt C, Patzakis M (2002) Periprosthetic total hip infection: outcomes using a staging system. Clin Orthop 403:8–15

    Article  Google Scholar 

  8. Rhee SJ, Cho JY, Choi YY, Sawaguchi T, Suh JT (2018) Femoral periprosthetic fractures after total knee arthroplasty: new surgically oriented classification with a review of current treatments. Knee Surg Relat Res 30(4):284–292

    Article  Google Scholar 

  9. Masri BA, Meek RMD, Duncan CP (2004) Periprosthetic fractures evaluation and treatment. Clin Orthop 420:80–95

    Article  Google Scholar 

  10. Xu BY, Yan S, Low LL, Vasanwala FF, Low SG (2019) Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review. BMC Musculoskelet Disord 20(1):568

    Article  Google Scholar 

  11. Warren J, Sundaram K, Anis H, McLaughlin J, Patterson B, Higuera CA et al (2019) The association between weight-bearing status and early complications in hip fractures. Eur J Orthop Surg Traumatol Orthop Traumato 29(7):1419–1427

    Article  Google Scholar 

  12. Ottesen TD, McLynn RP, Galivanche AR, Bagi PS, Zogg CK, Rubin LE et al (2018) Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted: an analysis of 4918 patients. Bone Jt J 100-B(10):1377–1384

    Article  CAS  Google Scholar 

  13. Haidukewych GJ, Israel TA, Berry DJ (2001) Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am 83(5):643–650

    Article  CAS  Google Scholar 

  14. Willoughby R (2005) Dynamic hip screw in the management of reverse obliquity intertrochanteric neck of femur fractures. Injury 36(1):105–109

    Article  CAS  Google Scholar 

  15. Streubel PN, Moustoukas MJ, Obremskey WT (2013) Mechanical failure after locking plate fixation of unstable intertrochanteric femur fractures. J Orthop Trauma 27(1):22–28

    Article  Google Scholar 

  16. Warwick DJ, Crichlow TP, Langkamer VG, Jackson M (1995) The dynamic condylar screw in the management of subtrochanteric fractures of the femur. Injury 26(4):241–244

    Article  CAS  Google Scholar 

  17. Sadowski C, Lübbeke A, Saudan M, Riand N, Stern R, Hoffmeyer P (2002) Treatment of reverse oblique and transverse intertrochanteric fractures with use of an intramedullary nail or a 95 degrees screw-plate: a prospective, randomized study. J Bone Joint Surg Am 84(3):372–381

    Article  Google Scholar 

  18. Kulkarni SS, Moran CG (2003) Results of dynamic condylar screw for subtrochanteric fractures. Injury 34(2):117–122

    Article  Google Scholar 

  19. Lehmann W, Rupprecht M, Nuechtern J, Melzner D, Sellenschloh K, Kolb J et al (2012) What is the risk of stress risers for interprosthetic fractures of the femur? A biomechanical analysis Int Orthop 36(12):2441–2446

    Article  Google Scholar 

  20. Valle Cruz JA, Urda AL, Serrano L, Rodriguez-Gonzalez FA, Otero J, Moro E et al (2016) Incidence of and risk factors for femoral fractures in the gap between hip and knee implants. Int Orthop 40(8):1697–1702

    Article  Google Scholar 

  21. Campillo-Recio D, Videla-Ces M, Sales-Pérez M, Molina-Olivella G, Videla S (2019) Inter-implant fractures: an unmet medical need-a preventive approach proposal. Eur J Orthop Surg Traumatol Orthop Traumatol. https://doi.org/10.1007/s00590-019-02581-6

    Article  Google Scholar 

  22. Stoffel K, Sommer C, Kalampoki V, Blumenthal A, Joeris A (2016) The influence of the operation technique and implant used in the treatment of periprosthetic hip and interprosthetic femur fractures: a systematic literature review of 1571 cases. Arch Orthop Trauma Surg 136(4):553–561

    Article  Google Scholar 

  23. Ciaffa V, Vicenti G, Mori CM, Panella A, Conserva V, Corina G et al (2018) Unlocked versus dynamic and static distal locked femoral nails in stable and unstable intertrochanteric fractures. A prospective study. Injury 49(Suppl 3):S19–S25

    Article  Google Scholar 

  24. Skála-Rosenbaum J, Džupa V, Bartoška R, Douša P, Waldauf P, Krbec M (2016) Distal locking in short hip nails: cause or prevention of peri-implant fractures? Injury 47(4):887–892

    Article  Google Scholar 

  25. Nakano S, Yoshioka S, Tezuka F, Nakamura M, Chikawa T, Shimakawa T (2013) New surgical treatment using a docking nail for postoperative periprosthetic femoral fracture after total hip arthroplasty. J Arthroplasty 28(2):326–330.

    Article  Google Scholar 

Download references

Funding

This study had no funding.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to José Vicente Andrés Peiró.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peiró, J.V.A., Ruiz, M.J., Hernández, J.T. et al. The inverted Vancouver C fracture. Case series of unstable proximal femur fractures above a knee revision stem treated by short cephalomedullary nail and lateral submuscular overlapping plate. Eur J Orthop Surg Traumatol 31, 193–198 (2021). https://doi.org/10.1007/s00590-020-02738-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-020-02738-8

Keywords

Navigation