title: Periprosthetic femoral fracture--a biomechanical comparison between Vancouver type B1 and B2 fixation methods.
abstract: Current clinical data suggest a higher failure rate for internal fixation in Vancouver type B1 periprosthetic femoral fracture (PFF) fixations compared to long stem revision in B2 fractures. The aim of this study was to compare the biomechanical performance of several fixations in the aforementioned fractures. Finite element models of B1 and B2 fixations, previously corroborated against in vitro experimental models, were compared. The results indicated that in treatment of B1 fractures, a single locking plate can be without complications provided partial weight bearing is followed. In case of B2 fractures, long stem revision and bypassing the fracture gap by two femoral diameters are recommended. Considering the risk of single plate failure, long stem revision could be considered in all comminuted B1 and B2 fractures.
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK; Medical and Biological Engineering, School of Engineering, University of Hull, Hull, UK. Electronic address: mehran_moazen@yahoo.com.
authors.forename: Mehran
authors.initials: M
authors.lastname: Moazen
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Mak
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Lee W
authors.initials: LW
authors.lastname: Etchels
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK; Institute of Advanced Manufacturing Technology, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, P.R. of China.
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Ruth K
authors.initials: RK
authors.lastname: Wilcox
authors.affiliation: Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Alison C
authors.initials: AC
authors.lastname: Jones
authors.affiliation: Academic Department of Orthopaedic and Trauma, University of Leeds, Leeds, UK; Department of Surgery and Cancer, Division of Surgery, Imperial College London, London, UK; Academic Orthopaedics and Trauma Unit, Aristotle University Medical School, University Campus, Thessaloniki, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D001860:Bone Plates; D017076:Computer-Aided Design; D005264:Femoral Fractures / Q000503:physiopathology / Q000601:surgery*; D020342:Finite Element Analysis; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D018460:Fractures, Comminuted / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D057068:Periprosthetic Fractures / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation / Q000295:instrumentation; D016474:Weight-Bearing
keywords: Vancouver type B; finite element method; fracture; stiffness; strain