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O2277 PERI-PROSTHETIC FRACTURES OF THE FEMUR. CLASSIFICATION AND TREATMENT-REVIEW OF 24 CASES



Abstract

Aim: We evaluated the Vancouver system of classiþcation and treatment of Periprosthetic fractures. Methods: There were 24 consecutive patients, 17 males and 7 females with a mean age of 78.9 yrs (range 67–88). Two type A fractures were both of the AG type and unstable, were revised with a cemented Exeter stem reinforced with strut grafts. Of the nineteen patients type B fractures, one a B1 that was þxed with the cable grip system and strut graft. The B2 fractures were revised with a long stem cemented Exeter component reinforced with strut grafts. All the B3 fractures were revised with a long stem uncemented component with strut grafts. Of the three type C fractures two were þxed with the plate and cable grip system and the third with a supracondylar nail. Results: The follow up was regular, mean duration being 18.5 months (range 6–26). The review was both clinical using the Harris Hip Score (HHS) and radio-graphic.22 patients had a good result with a mean HHS of 82.7 (range 80–86.4). Two patients had a poor result with a mean HHS of 70 (range69–71). These attributed to progressive Parkinsonñs disease and a loose contra-lateral Hip Replacement. Conclusions: The Vancouver classiþcation system is the only one of its type to be subjected to psychometric testing and show substantial agreement. Based on it appropriate treatment of each fracture can be instituted. It allows a more rational approach to treatment for fracture þxation but also addresses associated problems. Our experiences and results point to this way of treatment.

Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.