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Union rate, complication rate, and opioid usage after Vancouver B periprosthetic femur fractures: a comparison of fracture types

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Periprosthetic femur fractures are complex injuries that can be difficult to treat and recover from. With a growing number of total hip arthroplasties (THA) and revision arthroplasties being performed in an aging population, the incidence of these injuries is on the rise. Multiple studies exist detailing outcomes associated with periprosthetic femur fractures after THA, but no study has directly compared the post-operative course between fracture types as classified by the Vancouver classification system. This study compares the three Vancouver B fracture types to see if any type is associated with an increase in post-operative complications than others.

Materials and methods

This retrospective chart review was conducted at a suburban orthopedic surgery department. Overall, 122 patients who presented to our hospital with periprosthetic proximal femur fractures after hip arthroplasty over the past 13 years were reviewed. Patients were included if they underwent surgical stabilization of their femur fracture. Patients were excluded if they underwent non-operative treatment or had missing chart information. For each patient, demographic information, fracture information, surgical information, post-operative course, and post-operative opioid usage were recorded and compared among groups.

Results

Overall, 88 fractures were included. Fifty-five (62.5%) were Vancouver type B1, 27 (30.7%) were Vancouver type B2, and 6 (6.8%) were Vancouver type B3. Most of our patients were female (n = 62, 70.5%) and older than 81 years of age (n = 53, 60.2%) with uncemented prosthesis (n = 83, 94.3%). All three fracture groups had statistically similar union rates (p = 0.77), infection rates (p = 0.32), subsequent fractures (p = 0.63), repeat surgeries (p = 0.64), and post-operative opioid use (measured in milli-morphine equivalents) after surgical stabilization (p = 0.96).

Conclusions

While periprosthetic femur fractures after hip arthroplasty are associated with high complication rates and poor outcomes, there is no difference in union rate, infection rate, subsequent fractures, repeat surgery rate, and opioid usage between the different Vancouver B fracture types.

Level of evidence

Prognostic level III.

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Acknowledgements

We thank Aaron Leatherman for his help with data collection and analysis.

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Authors and Affiliations

  1. St. Luke’s University Hospital, Bethlehem, USA

    Ajith Malige, Shawn Yeazell & Chinenye Nwachuku

  2. Philadelphia College of Osteopathic Medicine, Philadelphia, USA

    Matthew Beck

  3. Lewis Katz School of Medicine at Temple University, Philadelphia, USA

    Franzes Anne Liongson

  4. Penn State Health Hershey Medical Center, Hershey, USA

    Henry Boateng

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  1. Ajith Malige
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  2. Shawn Yeazell
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  4. Franzes Anne Liongson
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Correspondence to Ajith Malige.

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CN is a consultant for Depuy/Synthes. All other authors have no conflicts to report.

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This article does not contain any studies with human participants or animals performed by any of the authors. IRB approval was obtained from the St. Luke’s University Hospital IRB committee.

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Malige, A., Yeazell, S., Beck, M. et al. Union rate, complication rate, and opioid usage after Vancouver B periprosthetic femur fractures: a comparison of fracture types. Arch Orthop Trauma Surg 141, 17–22 (2021). https://doi.org/10.1007/s00402-020-03410-w

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  • DOI: https://doi.org/10.1007/s00402-020-03410-w

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