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.

Overview

INTRODUCTION: Periprosthetic femoral fractures, which are likely to increase as the population ages and total hip arthroplasty becomes more prevalent¹, can be effectively managed by restoring femoral length via preoperative planning and surgical execution using a cementless, tapered, fluted stem. STEP 1 PREOPERATIVE PLAN: Template the contralateral, uninjured side. STEP 2 TEMPLATE THE FRACTURED SIDE: Identify the ideal COR on the injured side and template the femoral stem. STEP 3 ESTABLISH DEPTH OF REAMING: 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. RESULTS: We report on 14 (12 Vancouver type-B2 and 2 Vancouver type-B3) periprosthetic femoral fractures treated with the described method¹⁵.