As the number of hip arthroplasties performed continues to grow, increasingly complex
periprosthetic fractures are encountered. In particular, fractures occurring near
the tip of a well-fixed stem, classified as Vancouver B1, have been associated with
high rates of failure.
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,
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Numerous treatment strategies have been recommended including traditional plating,
locked plating, cortical allografts as well as retrograde nails overlapping the femoral
stem tip.
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,
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,
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The latter technique has been advocated as a less invasive method to stabilise periprosthetic
fractures in elderly, low-demand patients unfit for extensive surgical procedures.
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Here, we present the use of a retrograde nail overlapping a femoral stem in a young,
active patient as supplemental fixation to a lateral plate for the difficult situation
of a Vancouver B1 periprosthetic fracture proximal to an femoral shaft hypertrophic
nonunion.To read this article in full you will need to make a payment
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References
- Risk factors for failure after treatment of a periprosthetic fracture of the femur.Journal of Bone and Joint Surgery: British Volume. 2006; 88: 26-30
- Periprosthetic fractures evaluation and treatment.Clinical Orthopaedics and Related Research. 2004; 410: 80-95
- Principles of treatment for periprosthetic femoral shaft fractures around well-fixed total hip arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. 2009; 17: 677-688
- Retrograde nailing of femoral fractures distal to a Moore prosthesis.Journal of Orthopaedic Trauma. 1998; 12: 588-591
- Retrograde nailing of femoral fracture below a hip prosthesis: a case report.Journal of Bone and Joint Surgery: British Volume. 1998; 80: 282-283
- Retrograde bridging nailing of periprosthetic femoral fractures.Injury. 2007; 38: 958-964
- Epidemiology of periprosthetic femur fracture around a total hip arthroplasty.Injury. 2007; 38: 651-654
- Classification of the hip.Orthopedic Clinics of North America. 1999; 30: 215-220
- Retrograde bridging nail in periprosthetic femoral fracture treatment which allows direct weight bearing. Retrograde bridging nail in periprosthetic femoral fracture treatment which allows direct weight bearing.Proceedings of the Institution of Mechanical Engineers: Part H. 2008; 222: 620-635
Article info
Publication history
Accepted:
June 13,
2012
Identification
Copyright
© 2012 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
