Periprosthetic hip fractures: an update into their management and clinical outcomes
Nikolaos Patsiogiannis, Nikolaos K. Kanakaris, and Peter V. GiannoudisHip
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The Vancouver classification is still a useful tool of communication and stratification of periprosthetic fractures, but besides the three parameters it considers, clinicians should also assess additional factors.
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Combined advanced trauma and arthroplasty skills must be available in departments managing these complex injuries.
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Preoperative confirmation of the THA (total hip arthroplasty) stability is sometimes challenging. The most reliable method remains intraoperative assessment during surgical exploration of the hip joint.
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Certain B1 fractures will benefit from revision surgery, whilst some B2 fractures can be effectively managed with osteosynthesis, especially in frail patients.
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Less invasive osteosynthesis, balanced plate–bone constructs, composite implant solutions, together with an appropriate reduction of the limb axis, rotation and length are critical for a successful fixation and uneventful fracture healing.
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