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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
PERIPROSTHETIC FEMORAL FRACTURE TYPE B1 WITH NARROW MEDULLARY CANAL: A CASE REPORT
Author
Jeetendra Bajpai1*, Amitosh Mishra2, Sourav Shukla3, Nikhil Sachdeva4
Email
dr.jbajpaii@gmail.com
keyword
Periprosthetic, Femur fracture, Internal fixation, Encerclage.
Abstract
The number of hip and knee replacements is increasing with better life expectancy and so is the burden of revision surgery due to periprosthetic fractures. The incidence of intraoperative periprosthetic fractures in cementless total hip arthroplasty ranges from 1 to 20%, whereas in postoperative periprosthetic fractures, the incidence ranges between 1 and 4%. Periprosthetic fractures are associated with factors such as osteolysis, osteopenia and aseptic loosening of the implant and usually require operative treatment. A 61-year-old man presented in emergency with displaced fracture of neck of femur right, patient was operated and hemiarthroplasty was done. Three months after surgery the patient again had a fall from height. A diagnosis of Periprosthetic fracture Vancouver’s classification type B was made from the radiographs. It could not be made out whether the implant was stable or unstable hence could not be classified as B1 or B2, which was later done intraoperatively. The fracture was initially undisplaced which was later found to be displaced in serial radiographs. The recommended treatment according to Duncan and Masri for type B1 fractures is revision with long stem. The recommended treatment, bypass with longer stem, was impractical in this patient owing to his narrow medullary canal. Hence, open reduction internal fixation by locking compression plate and cerclage was successfully completed on the patient. The economic constraints of the patient had restricted the use of cable plate.
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