An algorithm for the treatment of Vancouver type B2 periprosthetic proximal femoral fractures.

Abstract

The number of individuals with periprosthetic fractures of the proximal part of the femur is increasing. Multiple treatment methods have been described but none that correlate to fracture type and few with mostly good-to-excellent results. This article describes an algorithmic reconstruction tactic for treating patients with periprosthetic fractures associated with a loose femoral component. The stem is approached through the fracture fragments. Reconstructing the tube of the proximal part of the femur with 18G cerclage wires allows for canal preparation and implantation of the new stem. Application of the allograft struts and cables maximizes the biomechanical integrity of the proximal part of the femur to promote fracture repair and implant fixation. No treatment failures have occurred as of this date.