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Review Question - QID 3114

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QID 3114 (Type "3114" in App Search)
In his first day home after undergoing a total hip arthroplasty a 65-year-old male falls down the stairs and sustains the fracture seen in Figure A and B. Intra-operative examination reveals the stem to be loose. What is the preferred treatment for this injury?
  • A
  • B

Open reduction internal fixation with cables and proximal femoral locking plate

12%

561/4670

Open reduction internal fixation with allograft strut and multiple cables

4%

186/4670

Revision femoral component with proximal femoral replacement

1%

43/4670

Revision femoral component with long stem diaphyseal press-fit stem

81%

3774/4670

Revision femoral component with cemented stem

2%

80/4670

  • A
  • B

Select Answer to see Preferred Response

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Figure A and B show a Vancouver B2 peri-prosthetic fracture with loose femoral stem. In Vancouver B2 periprosthetic femur fractures it is recommended that the fracture be stabilized with the use of an uncemented extensively porous coated femoral component. However, in order to increase the femoral strength similar to the contralateral side, the surgeon must bypass the most distal cortical deficiency by two cortices.

Greidanus et al is an Instructional Course Lecture highlighting the various methods of treatment for peri-prosthetic fractures depending on bone stock, fracture classification, and available implants.

Sledge et al described their technique in order to reconstruct the proximal femur as well as use a uncemented femoral stem to achieve good results.

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