Effect Analysis Of Postoperative Periprosthetic Femoral Fracture With Vancouver Type B2 And B3 Using Wagner Sl Revision Stem

Objective: Analyze the effect and complication of periprosthetic femoral fracture with Vancouver type B2 and B3 treated with revision surgery using Wagner SL revision stem.Methods: We retrospectively analyzed 23 patients with Vancouver type B2 and B3 periprosthetic femoral fracture,whom treated with revision surgery using Wagner SL revision stem in The first affiliated hospital of Xinjiang medical university From January2013 to September 2018.17 of these patients are classified to Vancouver type B2,6 of them were Vancouver type B3.According to Paprosky bone defect classification,type I in6 patients,type II in 4,type IIIA in 5 and type IIIB in1.The average age of patient was 65(29 to 92),the average follow-up was 3 years(6 months to 6 years),we collected the data of the fracture cause,perioperative Harris score,postoperative Harris score,diameter of femur shaft,the length of the prosthesis that surpass the distal fracture line,distance of prosthesis subsidence,ipsilateral limb length discrepancy(LLD),status of fracture healing and bone regeneration.These data were statistically analyzed to evaluate the efficacy of treatment.Results: Median harris scores for all patients increased from 6.19 to 80.69,with a statistically significant difference(P < 0.05).There were no deaths,no major nerve vascular damage,periprosthetic joint infection or dislocation was found in this study.one patient had secondary revision surgery after a week for the intraoperative fracture at the distal femur that didn’t known during the operation.The length of the prosthesis that surpass the distal fracture line is average quadruple of the diameter of the femur shaft,There were two patients less than double,but no further complication was found.At finalfollow-up of all the fracture showed solid union,bone restoration was observed in 11patients(68.8%).2 patient showed suspicious stem subsidence.There was two patients showed suspicious ipsilateral limb length discrepancy(LLD)that more than 2cm.Conclusion: Periprosthetic femoral fracture with Vancouver type B2 and B3 treated with revision surgery using Wagner SL revision stem can obtain satisfactory treatment results.