Vancouver tip B1 Periprostetik femoral kýrýklardan sonra kablo sabitlemenin sonuçlarý

AMAÇ: Bu çalýþmada Vancouver tip B1 periprostetik femur kýrýðý nedeniyle kablo plak fiksasyonu yapýlan hastalarý ve klinik sonuçlarýný deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: 2014-2019 yýllarý arasýnda periprostetik kýrýk nedeniyle opere edilen vancouver tip B1 hastalarý araþtýrýldý. Hastalarýn; yaþý, cinsiyeti, vücut kitle indeksi, takip süresi, ameliyat süresi, kanama miktarý, non-union oranlarý, periprostetik kýrýk öncesi son ameliyatlarý, son ameliyat ile periprostetik kýrk arasý geçen süre, implant sað kalýmý, hasta sað kalýmý ve komplikasyonlarý kaydedildi. Ayrýca bu hastalarýn postoperatif klinik fonksiyonlarýný da karþýlaþtýrýldý.
BULGULAR: Çalýþma kriterlerini (Vancouver tip B1 kýrýðý) karþýlayan 23 hasta belirlendi. Hastalarýn yaþ ortalamasý 60 (49-76), ortalama vücut kitle indeksi 26.3 (17.5-40.7) ve ameliyat sonrasý ortalama takip süresi 14 (6-36) aydý. Cinsiyet daðýlýmýna bakýldýðýnda 5 (%22) erkek ve 18 (%78) kadýndý. Kýrýk öncesi son ameliyat ile kýrýk arasýndaki ortalama süre 6 ay (0-30) idi. Ameliyat süresi ortalama 95 dakika (60-180) iken kanama miktarý ortalama 310 ml (150-600) idi. Hastalarýn fonksiyonel deðerlendirmeleri; Toplamda beþ hastada ameliyattan sonra ambulatuar yetenekleri azalmýþtý. Takiplerde 2 hastada non-union gözlendi ve bu hastalara tedavi için açýk cerrahi uygulandý.
SONUÇ: Periprostetik kýrýklarýn en sýk görülen formlarýndan biri olan Vancouver B1 tipi kýrýklarda kablo ve kilitli plak uygulamalarý baþarýlýdýr. Ame-liyat süresinin kýsa olmasý ve kan kaybýnýn az olmasý gibi nedenlerle öne çýkan bu tedavi yönteminde komplikasyon durumunda revizyon artroplasti seçeneði devam etmektedir.

Outcomes of cable fixation after Vancouver type B1 periprosthetic femoral fractures

BACKGROUND: In this study, it was aimed to evaluate the patients who underwent cable plate fixation due to a Vancouver-type B1 periprosthetic femur fracture and their clinical results.
METHODS: Vancouver-type B1 patients who were operated on for periprosthetic fractures between 2014 and 2019 were investi-gated. Age, gender, body mass index (BMI), follow-up time, operation time, bleeding amount, non-union fracture, last surgery before fracture, the time between previous surgery and fracture, implant survival, patient survival, and complications were recorded. In addi-tion, the postoperative clinical functions of these patients were compared.
RESULTS: 23 patients who met the study criteria (Vancouver type B1 fracture) were identified. The mean age of the patients was 60 (49–76) years, the mean BMI was 26.3 (17.5–40.7), and the postoperative mean follow-up period was 14 (6–36) months. Considering the gender distribution, there were 5 (22%) men and 18 (78%) women. The mean time between the last surgery before the fracture and the fracture was 6 months (0–30). While the mean operation time was 95 min (60–180), the average amount of bleeding was 310 mL (150–600). Functional evaluations of patients: In total, five patients had decreased ambulatory abilities after surgery. Nonunion was observed in 2 patients during the follow-ups, and these patients underwent open surgery for treatment.
CONCLUSION: Cable and locking plate applications are successful in Vancouver type B1 fractures, which are one of the most common forms of periprosthetic fractures. In this technique, the duration of the operation can be shortened under ideal conditions, and the need for blood and blood products is reduced as blood loss is reduced. If there is a complication, you still have the chance to treat it with the option of revision arthroplasty.