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Original Article
The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures
Bo-Ram Na, M.D., Taek-Rim Yoon, M.D., Ph.D., Kyung-Soon Park, M.D., Ph.D.
Journal of the Korean Fracture Society 2016;29(1):26-33.
DOI: https://doi.org/10.12671/jkfs.2016.29.1.26
Published online: January 19, 2016

Department of Orthopaedic Surgery, Chonnam National University Medical School, Gwangju, Korea.

Address reprint requests to: Taek-Rim Yoon, M.D., Ph.D. Department of Orthopaedic Surgery, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. Tel: 82-62-227-1640, Fax: 82-62-227-7794, tryoon@chonnam.ac.kr
• Received: December 30, 2014   • Revised: July 24, 2015   • Accepted: November 30, 2015

Copyright © 2016 The Korean Fracture Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF).
  • Materials and Methods
    Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared.
  • Results
    The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3° (105°-140°) in the DCP group and 118.4° (110°-140°) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups.
  • Conclusion
    A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.
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Fig. 1

A 46-year-old male patient with a Vancouver type B1 periprosthetic fracture treated with open reduction and internal fixation dynamic compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 3-year plain radiograph.

jkfs-29-26-g001.jpg
Fig. 2

A 72-year-old male patient with a Vancouver type C periprosthetic fracture treated with open reduction and internal fixation locking compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 1-year plain radiograph.

jkfs-29-26-g002.jpg
Table 1

Demographic Data of the Two Groups

jkfs-29-26-i001.jpg
Variable DCP (n=12) LCP (n=8)
Sex (male/female) 8/4 3/5
Age (yr) 59.3 (43-80) 76.1 (70-85)
Vancouver classification
 B1 4 1
 C 8 7
Follow-up duration (mo) 43.2 (13-102) 30.2 (12-71)
Time interval from primary THA (mo) 96.8 (11-240) 66.4 (2-300)

Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate, THA: Total hip arthroplasty.

Table 2

Clinical Outcomes of the Two Groups

jkfs-29-26-i002.jpg
Variable DCP LCP
Preoperative Postoperative Preoperative Postoperative
HHS (0-100), median (range) 94.3 (86-100) 90.8 (79-96) 94.6 (82-100) 90.5 (64-96)
 Pain (0-44), mean 41.7 39.8 40.8 37.2
 Function (0-47), mean 44.6 42 45.8 44.3
 Absenece of deformity (0-4), mean 4 4 4 4
 ROM (0-5), mean 5 5 5 5
Walking ability, n
 Independent walking, n 12 10 8 8
 Crutch ambulation, n 0 2 0 0
 Wheelchair ambulation, n 0 0 0 0
Knee ROM (°), median (range) 103.3 (105-140) 118.4 (110-140)

DCP: Dynamic compression plate, LCP: Locking compression plate, HHS: Harris hip score, ROM: Range of motion.

Table 3

Radiographical Findings of the Two Groups

jkfs-29-26-i003.jpg
Union of fracture site DCP LCP
Union 10 7
Delayed-union 2 1
Union period (mo) 5.5 (3-6) 5 (3-6)
Other complication
 Infection 2 0
 Metal breakage 1 1
Total 3 1

Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate.

Figure & Data

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        The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures
        J Korean Fract Soc. 2016;29(1):26-33.   Published online January 31, 2016
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      The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures
      Image Image
      Fig. 1 A 46-year-old male patient with a Vancouver type B1 periprosthetic fracture treated with open reduction and internal fixation dynamic compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 3-year plain radiograph.
      Fig. 2 A 72-year-old male patient with a Vancouver type C periprosthetic fracture treated with open reduction and internal fixation locking compression plate and screws. (A) Preoperative radiograph. (B) Immediate postoperative radiograph. (C) Postoperative 1-year plain radiograph.
      The Clinical and Radiological Results of Vancouver Type B1 and C Periprosthetic Fractures

      Demographic Data of the Two Groups

      Variable DCP (n=12) LCP (n=8)
      Sex (male/female) 8/4 3/5
      Age (yr) 59.3 (43-80) 76.1 (70-85)
      Vancouver classification
       B1 4 1
       C 8 7
      Follow-up duration (mo) 43.2 (13-102) 30.2 (12-71)
      Time interval from primary THA (mo) 96.8 (11-240) 66.4 (2-300)

      Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate, THA: Total hip arthroplasty.

      Clinical Outcomes of the Two Groups

      Variable DCP LCP
      Preoperative Postoperative Preoperative Postoperative
      HHS (0-100), median (range) 94.3 (86-100) 90.8 (79-96) 94.6 (82-100) 90.5 (64-96)
       Pain (0-44), mean 41.7 39.8 40.8 37.2
       Function (0-47), mean 44.6 42 45.8 44.3
       Absenece of deformity (0-4), mean 4 4 4 4
       ROM (0-5), mean 5 5 5 5
      Walking ability, n
       Independent walking, n 12 10 8 8
       Crutch ambulation, n 0 2 0 0
       Wheelchair ambulation, n 0 0 0 0
      Knee ROM (°), median (range) 103.3 (105-140) 118.4 (110-140)

      DCP: Dynamic compression plate, LCP: Locking compression plate, HHS: Harris hip score, ROM: Range of motion.

      Radiographical Findings of the Two Groups

      Union of fracture site DCP LCP
      Union 10 7
      Delayed-union 2 1
      Union period (mo) 5.5 (3-6) 5 (3-6)
      Other complication
       Infection 2 0
       Metal breakage 1 1
      Total 3 1

      Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate.

      Table 1 Demographic Data of the Two Groups

      Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate, THA: Total hip arthroplasty.

      Table 2 Clinical Outcomes of the Two Groups

      DCP: Dynamic compression plate, LCP: Locking compression plate, HHS: Harris hip score, ROM: Range of motion.

      Table 3 Radiographical Findings of the Two Groups

      Values are presented as number only or median (range). DCP: Dynamic compression plate, LCP: Locking compression plate.


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