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PMID- 28363890
DA  - 20170401
DCOM- 20170412
LR  - 20170412
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 99-B
IP  - 4 Supple B
DP  - 2017 Apr
TI  - A systematic review of Vancouver B2 and B3 periprosthetic femoral fractures.
PG  - 17-25
LID - 10.1302/0301-620X.99B4.BJJ-2016-1311.R1 [doi]
AB  - AIMS: The aim of this study was to investigate the outcomes of Vancouver type B2 
      and B3 fractures by performing a systematic review of the methods of surgical
      treatment which have been reported. MATERIALS AND METHODS: A systematic search
      was performed in Ovid MEDLINE, Embase and the Cochrane Central Register of
      Controlled Trials. For inclusion, studies required a minimum of ten patients with
      a Vancouver type B2 and/or ten patients with a Vancouver type B3 fracture, a
      minimum mean follow-up of two years and outcomes which were matched to the type
      of fracture. Studies were also required to report the rate of re-operation as an 
      outcome measure. The protocol was registered in the PROSPERO database. RESULTS: A
      total of 22 studies were included based on the eligibility criteria, including
      343 B2 fractures and 167 B3 fractures. The mean follow-up ranged from 32 months
      to 74 months. Of 343 Vancouver B2 fractures, the treatment in 298 (86.8%)
      involved revision arthroplasty and 45 (12.6%) were treated with internal fixation
      alone. A total of 37 patients (12.4%) treated with revision arthroplasty and six 
      (13.3%) treated by internal fixation only underwent further re-operation. Of 167 
      Vancouver B3 fractures, the treatment in 160 (95.8%) involved revision
      arthroplasty and eight (4.8%) were treated with internal fixation without
      revision. A total of 23 patients (14.4%) treated with revision arthroplasty and
      two (28.6%) treated only with internal fixation required re-operation.
      CONCLUSION: A significant proportion, particularly of B2 fractures, were treated 
      without revision of the stem. These were associated with a higher rate of
      re-operation. The treatment of B3 fractures without revision of the stem resulted
      in a high rate of re-operation. This demonstrates the importance of careful
      evaluation and accurate characterisation of the fracture at the time of
      presentation to ensure the correct management. There is a need for improvement in
      the reporting of data in case series recording the outcome of the surgical
      treatment of periprosthetic fractures. We have suggested a minimum dataset to
      improve the quality of data in studies dealing with these fractures. Cite this
      article: Bone Joint J 2017;99-B(4 Supple B):17-25.
CI  - (c)2017 Khan et al.
FAU - Khan, T
AU  - Khan T
AD  - University of Nottingham, Nottingham NG7 2NR, UK.
FAU - Grindlay, D
AU  - Grindlay D
AD  - University of Nottingham, Nottingham NG7 2NR, UK.
FAU - Ollivere, B J
AU  - Ollivere BJ
AD  - University of Nottingham, Nottingham NG7 2NR, UK.
FAU - Scammell, B E
AU  - Scammell BE
AD  - University of Nottingham, Nottingham NG7 2NR, UK.
FAU - Manktelow, A R J
AU  - Manktelow AR
AD  - Nottingham University Hospitals NHS Trust, Nottingham, UK.
FAU - Pearson, R G
AU  - Pearson RG
AD  - University of Nottingham, Nottingham NG7 2NR, UK.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Arthroplasty, Replacement, Hip/*methods
MH  - Femoral Fractures/*surgery
MH  - Fracture Fixation, Internal/*methods
MH  - Hip Prosthesis
MH  - Humans
MH  - Periprosthetic Fractures/*surgery
MH  - Prosthesis Design
MH  - Prosthesis Failure
MH  - Reoperation/methods
OT  - *Periprosthetic fracture
OT  - *Revision hip arthroplasty
OT  - *Systematic review
OT  - *Vancouver classification
EDAT- 2017/04/02 06:00
MHDA- 2017/04/13 06:00
CRDT- 2017/04/02 06:00
PHST- 2016/12/11 [received]
PHST- 2017/01/09 [accepted]
AID - 99-B/4_Supple_B/17 [pii]
AID - 10.1302/0301-620X.99B4.BJJ-2016-1311.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2017 Apr;99-B(4 Supple B):17-25. doi:

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