title: [Evaluation of the results of the treatment of Vancouver B1 periprosthetic fractures and proposed indications for the use of cortical allograft as part of the fixation].
abstract: Currently there is limited information on the indications for the use of cortical allograft for the treatment of periprosthetic fractures on a stable stem. The purpose of this study was to retrospectively evaluate the treatment and the results obtained in this type of fractures and propose a series of criteria for the use of cortical allograft. Between 2003 and 2008 a total of 31 periprosthetic femur fractures were treated at our institution. Twelve of them were classified as B1: 6 were treated with a Dall-Miles (Stryker) system plate and 6 with the same plate supplemented with a structural cortical allograft over the medial cortex of the femur (DM and DM-Allo groups, respectively). An evaluation of the clinical and radiologic results was performed in the latest follow-up available. A patient in the DM-Allo group had rupture of a screw and 10 degrees varization; the fracture healed despite this and the patient had a satisfactory clinical course. The Oxford Hip Score was 9 points lower in the DM group compared with the DM-Allo group, and the EQ-5D health scale was 0.10 better for the DM group. The DM-Allo group had a longer hospital stay and more transfusion-related requirements. We think that the patients with clinical or radiologic criteria of osteoporotic bone may benefit from the use of a cortical allograft to favor healing and increase the bone stock. However, those advantages should be weighed considering the higher risk of surgical-related morbidity associated with the surgical insult.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínic Provincial de Barcelona. drfont@comb.es
authors.forename: L
authors.initials: L
authors.lastname: Font-Vizcarra
authors.forename: E
authors.initials: E
authors.lastname: Muñoz-Mahamud
authors.forename: J A
authors.initials: JA
authors.lastname: Fernández-Valencia
authors.forename: X
authors.initials: X
authors.lastname: Gallart
authors.forename: S
authors.initials: S
authors.lastname: Prat
authors.forename: J
authors.initials: J
authors.lastname: Riba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D057068:Periprosthetic Fractures / Q000145:classification / Q000601:surgery*; D012189:Retrospective Studies