Acta Ortopédica Mexicana

Font-Vizcarra L, Muñoz-Mahamud E, Fernández-Valencia JA, Gallart X, Prat S, Riba J
Evaluation of the results of the treatment of Vancouver B1 periprosthetic fractures and proposed indications for the use of cortical allograft as part of the fixation
Acta Ortop Mex 2010; 24 (4)

Language: Español
References: 23
Page: 215-219
PDF: 0. Kb.

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ABSTRACT

Currently there is limited information on the indications for the use of cortical allograft for the treatment of periprosthetic fractures on a stable stem. The purpose of this study was to retrospectively evaluate the treatment and the results obtained in this type of fractures and propose a series of criteria for the use of cortical allograft. Between 2003 and 2008 a total of 31 periprosthetic femur fractures were treated at our institution. Twelve of them were classified as B1: 6 were treated with a Dall-Miles (Stryker®) system plate and 6 with the same plate supplemented with a structural cortical allograft over the medial cortex of the femur (DM and DM-Allo groups, respectively). An evaluation of the clinical and radiologic results was performed in the latest follow-up available. A patient in the DM-Allo group had rupture of a screw and 10° varization; the fracture healed despite this and the patient had a satisfactory clinical course. The Oxford Hip Score was 9 points lower in the DM group compared with the DM-Allo group, and the EQ-5D health scale was 0.10 better for the DM group. The DM-Allo group had a longer hospital stay and more transfusion-related requirements. We think that the patients with clinical or radiologic criteria of osteoporotic bone may benefit from the use of a cortical allograft to favor healing and increase the bone stock. However, those advantages should be weighed considering the higher risk of surgical-related morbidity associated with the surgical insult.


Key words: fracture, periprosthetic fracture, treatment of periprosthetic fractures.