Treatment of B1 Distal Periprosthetic Femur Fractures.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosure The authors have no commercial or financial conflicts of interest to disclose. There were no funding sources for any of the authors listed. 9. J Orthop Trauma. 2015 Dec;29 Suppl 12(0 12):S28-33. doi: 10.1097/BOT.0000000000000467. Biomechanical Concepts for Fracture Fixation. Bottlang M(1), Schemitsch CE, Nauth A, Routt M Jr, Egol KA, Cook GE, Schemitsch EH. Author information: (1)*Portland Biomechanics Laboratory, Legacy Research Institute, Portland, OR; †Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada; ‡Division of Orthopaedic Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; §Department of Orthopedic Surgery and Sports Medicine, University of Texas Health Science Center at Houston, Houston, TX; ‖NYU Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, NY; ¶Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada; and **University of Toronto, Toronto, ON, Canada. Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability. For unstable sacral fractures with vertical or multiplanar instabilities, "standard" iliosacral screw fixation is not sufficient. Periprosthetic femur fractures, in particular Vancouver B1 fractures, have increased stability when using 90/90 fixation versus a single locking plate. Far cortical locking combines the concept of dynamization with locked plating to achieve superior healing of a distal femur fracture. Finally, there is no ideal construct for syndesmotic fracture stabilization; however, these fractures should be fixed using a device that allows for sufficient motion in the syndesmosis. In general, orthopaedic surgeons should select a fracture fixation construct that restores stability and promotes healing at the fracture site, while reducing the potential for fixation failure. DOI: 10.1097/BOT.0000000000000467 PMCID: PMC4654707