Management of Vancouver B2 and B3 Periprosthetic Proximal Femoral Fractures by Distal Locking Femoral Stem (Cannulok) in Patients 75 Years and Older.
Periprosthetic fracture following total hip arthroplasty is a significant problem faced by hip surgeons, and its management in elderly patients remains a considerable challenge.



We retrospectively reviewed 28 Vancouver B2 and B3 periprosthetic femoral fractures (PFF) treated with revision of the femoral stems by distally locked, hydroxyapatite-coated uncemented stems (Cannulok). Patients were aged 75 years or older at the time of surgery.



The mean follow-up was 44.6 months (range, 24-102). The mean postoperative Oxford hip score was 30.1 (range, 10-46). The rate of fracture union was 95.8%, and the survivorship of the stem was 100% at the end of follow-up.



The management of PFF in elderly is associated with increased postoperative morbidity and mortality. The use of a distally locked, hydroxyapatite-coated femoral stem is a valid option for the treatment of PFF to achieve fracture union with a low rate of revision.
Department of Orthopaedic Surgery, Royal Berkshire Hospital, Reading, UK; Department of Orthopaedic Surgery and Trauma, University of Alexandria, Alexandria, Egypt.
Ahmed
A
El-Bakoury
Department of Orthopaedic Surgery and Trauma, University of Alexandria, Alexandria, Egypt; Department of Orthopaedic Surgery, Derriford Hospital, Plymouth, UK.
Hazem
H
Hosny
Department of Orthopaedic Surgery, Derriford Hospital, Plymouth, UK.
Mark
M
Williams
Department of Orthopaedic Surgery, Derriford Hospital, Plymouth, UK.
Jonathan
J
Keenan
Department of Orthopaedic Surgery, Derriford Hospital, Plymouth, UK.
Rathan
R
Yarlagadda
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D017886:Durapatite; D005260:Female; D005264:Femoral Fractures; D005269:Femur / Q000601:surgery; D006620:Hip Fractures / Q000209:etiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies
D017886:Durapatite
Cannulok; distally locked stem; elderly; periprosthetic femoral fractures; revision hip arthroplasty