Application of modified extended trochanteric osteotomy in revision of Vancouver B2/B3 periprosthetic femoral fractures
10.3760/cma.j.cn115530-20240410-00161
- VernacularTitle:改良大转子延长截骨术在Vancouver B2、B3型股骨假体周围骨折翻修术中的应用
- Author:
Bo SUN
1
;
Qianlong ZHANG
;
Kewei LI
;
Shaohua WANG
;
Aiguo WANG
;
Jinliang WANG
Author Information
1. 郑州市骨科医院关节病科Ⅱ，郑州 450000
- Keywords:
Femoral fractures;
Arthroplasty, replacement, hip;
Osteotomy;
Periprosthetic femoral fracture;
Modified extended trochanteric osteotomy
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(10):872-877
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate modified extended trochanteric osteotomy (ETO) applied in the revision of Vancouver B2/B3 periprosthetic femoral fractures (PFF).Methods:A retrospective study was conducted to analyze the 35 patients with Vancouver B2/B3 PFF who had been treated at Joint Disease Department Ⅱ, Zhengzhou Orthopedic Hospital from January 2012 to November 2020. There were 10 males and 15 females with an age of (74.3±7.8) years. The time from their primary replacement to revision was (120.3±28.6) months. By the Vancouver classification, 26 cases were type B2 and 9 ones type B3. The modified ETO was used in the revision surgery for all patients. The clinical efficacy was evaluated using Harris hip score, imaging evaluation was performed using the Beals and Tower criteria at the last follow-up, and complications were recorded.Results:The operation time for this cohort was (148±32) min and intraoperative bleeding (800±150) mL. All patients were followed up for (45.2±15.3) months. The Harris score increased significantly from preoperative (21.3±11.2) points to (86.2±5.2) points at the last follow-up ( P < 0.001). By the Beals and Tower evaluation, 9 cases were rated as excellent, 24 cases as good, and 2 as poor. All the fractures and sites of trochanteric osteotomy got healed after (4.4±2.8) months except for 1 case of nonunion. Prosthesis subsidence occurred in 3 cases, in 2 of which the subsidence stopped 6 months later and in only 1 of which revision was needed due to the subsidence. Upward block displacement of the greater trochanteric fracture occurred in 2 cases, but did not exceed 1 cm. One case of postoperative dislocation responded to manual reduction. Conclusion:In the revision of Vancouver B2/B3 PFF, the modified ETO can improve fracture healing, and reduce postoperative dislocations and complications, leading to satisfactory clinical efficacy.
