J Korean Fract Soc.  2016 Jan;29(1):26-33. 10.12671/jkfs.2016.29.1.26.

The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures

• Na BR
• Yoon TR
• Park KS

• KMID: 2183762
• DOI: http://doi.org/10.12671/jkfs.2016.29.1.26

Abstract

PURPOSE
The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF).
MATERIALS AND METHODS
Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared.
RESULTS
The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3degrees (105degrees-140degrees) in the DCP group and 118.4degrees (110degrees-140degrees) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups.
CONCLUSION
A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.

Keyword

Total hip arthroplasty; Periprosthetic femoral fracture; Vancouver type B1 and C; Dynamic compression plate; Locking compression plate

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip
Classification
Femoral Fractures
Follow-Up Studies
Hip
Humans
Knee
Knee Joint
Periprosthetic Fractures*
Range of Motion, Articular
Walking

Figure

• 

  Fig. 1 A 46-year-old male patient with a Vancouver type B1 periprosthetic fracture treated with open reduction and internal fixation dynamic compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 3-year plain radiograph.

• 

  Fig. 2 A 72-year-old male patient with a Vancouver type C periprosthetic fracture treated with open reduction and internal fixation locking compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 1-year plain radiograph.

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