Periprosthetic fractures of the proximal femur—Vancouver A type fracture

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• 作者：P. Potocnik (1)
  L. Puig (2)
  C. Candrian (1)
  
• 关键词：Arthroplasty ; Periprosthetic fractures ; Vancouver A type fracture
• 刊名：European Orthopaedics and Traumatology
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：4
• 期：2
• 页码：73-75
• 全文大小：113KB
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• 作者单位：P. Potocnik (1)
  L. Puig (2)
  C. Candrian (1)
  
  1. Department of Surgery and Orthopaedics, Ospedale Regionale Lugano, Lugano, Switzerland
  2. Department of Orthopaedic Surgery, Hospital del Mar i l’Esperan?a-Parc de Salut MAR, Barcelona, Spain
  

文摘

Introduction Today, we encounter an increasingly high need for arthroplasty, with a high number of total hip arthroplasties. With this, complications also rise, such as periprosthetic fractures. The purpose of this article is to briefly expose the periprosthetic fracture type Vancouver A, which is located either around the greater or the lesser trochanter. Lesser trochanter fractures The fractures of the lesser trochanter occur either through a low-energy trauma or spontaneously in the context of an osteolysis after loosening of the stem. The healing can mostly be achieved conservatively. In rare cases, an operative treatment must be considered, as in cases of osteolysis or lack of medial support, where a stem revision can become necessary. Greater trochanter fractures Also, the greater trochanter fractures are an entity of low-energy trauma. In cases of little displacement or in patients with low demand, a conservative treatment is indicated. For all other cases, there are a number of different methods of fixation. They range from wire cerclages to angular stable plates or even gluteus maximus/fascia lata flap transfer. However, a relatively high incidence of non-unions has been reported with different fixation techniques. The high incidence of non-union of periprosthetic fractures of the greater trochanter could eventually solved with the use of angular stable implants. There seem to be certain advantages, but further and larger studies will be necessary to prove its value.