Management of Vancouver B2 and B3 Periprosthetic Proximal Femoral Fractures by Distal Locking Femoral Stem (Cannulok) in Patients 75 Years and Older

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• 作者：Ahmed El-Bakoury ; FRCS (Orth)^a ; ^b ; ; Hazem Hosny ; FRCS (Orth)^b ; ^c ; Mark Williams ; FRCS (Orth)^c ; Jonathan Keenan ; FRCS (Orth)^c ; Rathan Yarlagadda ; FRCS (Orth)^c
• 关键词：periprosthetic femoral fractures ; Cannulok ; distally locked stem ; revision hip arthroplasty ; elderly
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：32
• 期：2
• 页码：541-545
• 全文大小：516 K
• 卷排序：32

文摘

Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge.MethodsWe retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery.ResultsThe mean follow-up was 44.6 months (range, 24-102). The mean postoperative Oxford hip score was 30.1 (range, 10-46). The rate of fracture union was 95.8%, and the survivorship of the stem was 100% at the end of follow-up.ConclusionThe management of PFF in elderly is associated with increased postoperative morbidity and mortality. The use of a distally locked, hydroxyapatite-coated femoral stem is a valid option for the treatment of PFF to achieve fracture union with a low rate of revision.