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Lower reoperation rate with locking plates compared with conventional plates in Vancouver type C periprosthetic femoral fractures: A register study of 639 cases in Sweden

Artikel i vetenskaplig tidskrift
Författare Georgios Chatziagorou
Hans Lindahl
Johan Kärrholm
Publicerad i Injury
Volym 50
Nummer/häfte 12
Sidor 2292-2300
ISSN 0020-1383
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 2292-2300
Språk en
Länkar https://doi.org/10.1016/j.injury.20...
Ämnesord Femoral fracture, Hip, Interprosthetic fracture, Locking plate, Mortality, Outcomes, Periprosthetic fracture
Ämneskategorier Ortopedi

Sammanfattning

Aim: To investigate demographics and outcomes of Vancouver type C periprosthetic femoral fractures (PPFF) treated with open reduction and internal fixation. Methods: Patient data were obtained from medical charts of cases reported to the Swedish Hip Arthroplasty Register and/or from the National Patient Register. Vancouver type C fractures undergoing surgery between 2001 and 2011, in patients who had received their primary THR between 1979 and 2011, were included. Any further reoperation performed between 2001 and 2013 and related to the PPFF constituted the primary outcome. Results: A total of 632 patients with 639 Vancouver type C fractures were identified. The majority of the patients were women (84%) and they had a fracture distal to a cemented stem (95%). The mean age at the time of fracture was 72 years. Treatment was performed with a locking plate (363 cases), a conventional plate (184 cases), an intramedullary nail (62 cases), or with double plating (30 cases). The overall reoperation rate was 17%, and mortality within one year of the operation was 16%. Locking plates had a significantly lower reoperation rate than conventional plates (p<0.001) and intramedullary nailing (p = 0.005). Interprosthetic femoral fractures did not have a statistically different outcome compared with non-IPFFs. Conclusions: The lowest reoperation rate was observed using locking plates in Vancouver type C fractures when compared with conventional plates or intramedullary nailing. The presence of an ipsilateral knee prosthesis did not influence the outcome of the surgical treatment.

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