Plate fixation in periprosthetic femur fractures Vancouver type B1: preliminary report of macroscopic evaluation of the cement mantle and short literature review

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Luigi Bibiano
Grigor Stamboltsyan
Georgios Touloupakis
Stefano Ghirardelli
Elena Biancardi
Giuseppe Edoardo Giovanni Longo
Guido Antonini
Cornelio Crippa

Keywords

cement mantle, periprosthetic Vancouver B1 femur fractures, hip stem stability

Abstract

he goal of our preliminary report is to investigate hip stem stability and intra-operative cement mantle integrity after screw insertion in plate fixation of periprosthetic Vancouver B1 femur fractures. From a cohort of 50 patients with a periprosthetic femur fracture treated in our department from February 2012 until February 2017, we included in our study patients with a periprostethic Vancouver B1 femoral fracture in cemented hip arthroplasty and hemiarthroplasty, operated with ORIF using a 4.5/5.0 LCP Proximal Femoral Hook Plate ® (Synthes, Switzerland) with at least one screw perforating the cement mantle. Anteroposterior and lateral femur views and pelvis X-rays were performed preoperatively. The stability of the hip implant and the cemented mantle integrity was evaluated intra-operatively in a macroscopic way and with a post-operative X-ray in anteroposterior and lateral views. Only 7 patients satisfied the inclusion criteria; no lesion/break of the cement mantle occurred intra-operatively at any step during drilling or screw insertion, also confirmed with C-arm assessment. No cases of stem mobilization were found and cement mantle integrity was maintained in every case. Insertion of screws around a cemented stem for plate fixation in periprosthetic femur fractures Vancouver type B1 could be considered a safe procedure. However, further and more extended studies are necessary for proving additional knowledge at the evaluation of the cement mantle in osteosynthesis procedures.

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