Management of Vancouver Type-B2 and B3 Periprosthetic Femoral Fractures: Restoring Femoral Length via Preoperative Planning and Surgical Execution Using a Cementless, Tapered, Fluted Stem.

Rodriguez, José A; Berliner, Zachary P; Williams, Carlos A; Robinson, Jonathan; Hepinstall, Matthew S; Cooper, H John · JBJS Essent Surg Tech · 2017

case_series · Level IV

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Abstract

Periprosthetic femoral fractures, which are likely to increase as the population ages and total hip arthroplasty becomes more prevalent<sup>1</sup>, can be effectively managed by restoring femoral length via preoperative planning and surgical execution using a cementless, tapered, fluted stem. Template the contralateral, uninjured side. Identify the ideal COR on the injured side and template the femoral stem. Use stem templates to establish a reference point on the reamer for use intraoperatively, and identify the distance from that point to an identifiable distal landmark. We report on 14 (12 Vancouver type-B2 and 2 Vancouver type-B3) periprosthetic femoral fractures treated with the described method<sup>15</sup>.

Anatomy