Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures
Abstract To investigate the clinical effects of specific Unified Classification System B (UCS B)-lesser trochanter periprosthetic fractures and determine whether they occur only with non-cemented stems. A retrospective analysis of 28 patients with specific UCS B2 fractures who underwent two surgical...
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| Format: | Article |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41698-x |
| _version_ | 1797452808497135616 |
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| author | Wei-Qiang Zhao Xu-Song Li Meng-Qiang Fan Zhi-Yuan Yao Zhou-Feng Song Pei-Jian Tong Jie-Feng Huang |
| author_facet | Wei-Qiang Zhao Xu-Song Li Meng-Qiang Fan Zhi-Yuan Yao Zhou-Feng Song Pei-Jian Tong Jie-Feng Huang |
| author_sort | Wei-Qiang Zhao |
| collection | DOAJ |
| description | Abstract To investigate the clinical effects of specific Unified Classification System B (UCS B)-lesser trochanter periprosthetic fractures and determine whether they occur only with non-cemented stems. A retrospective analysis of 28 patients with specific UCS B2 fractures who underwent two surgical treatments, longer stem revision and internal fixation (LSRIF) and open reduction and internal fixation (ORIF), was performed. The patients were assessed at 1, 3, 6, 12, and 24 months and annually thereafter. Fracture healing, complications, Harris Hip Score (HHS), and the Short Form Health Survey questionnaire (SF-36) quality of life score were assessed at each follow-up. At the time of the last follow-up, seven patients had been lost: three were lost to contact, two died, and two were hospitalised elsewhere and unavailable for follow-up. The remaining 21 patients were followed for an average of 49.3 ± 15.4 (range: 24–74.4) months. Their average fracture healing time was 13.5 ± 1.1 (12–15.4) weeks. Complications included three cases (10.71%) of thrombus, one (3.57%) of heart failure, and one (3.57%) of pulmonary infection. There were no revisions due to prosthesis loosening, subsidence, or infection. At the last follow-up, the HHS, SF-36 mental score, and SF-36 physical score were recorded, LSRIF vs. ORIF (82.9 ± 6.6 vs. 74.7 ± 3.9, p = 0.059; 50.9 ± 7.6 vs. 38 ± 1.4, p = 0.012, and 51.7 ± 8.4 vs. 39.7 ± 3.4, p = 0.032, respectively). Specific UCS B2 fractures mostly occur with non-cemented stems. LSRIF with cables is the main treatment, while ORIF is an option for those elderly in poor condition. |
| first_indexed | 2024-03-09T15:14:01Z |
| format | Article |
| id | doaj.art-bcfe0de15fc4480a92e19bc57d581dad |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:14:01Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bcfe0de15fc4480a92e19bc57d581dad2023-11-26T13:12:16ZengNature PortfolioScientific Reports2045-23222023-08-011311810.1038/s41598-023-41698-xSurgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fracturesWei-Qiang Zhao0Xu-Song Li1Meng-Qiang Fan2Zhi-Yuan Yao3Zhou-Feng Song4Pei-Jian Tong5Jie-Feng Huang6Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopaedics and Traumatology, Zhongshan Hospital of Traditional Chinese MedicineDepartment of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical UniversityAbstract To investigate the clinical effects of specific Unified Classification System B (UCS B)-lesser trochanter periprosthetic fractures and determine whether they occur only with non-cemented stems. A retrospective analysis of 28 patients with specific UCS B2 fractures who underwent two surgical treatments, longer stem revision and internal fixation (LSRIF) and open reduction and internal fixation (ORIF), was performed. The patients were assessed at 1, 3, 6, 12, and 24 months and annually thereafter. Fracture healing, complications, Harris Hip Score (HHS), and the Short Form Health Survey questionnaire (SF-36) quality of life score were assessed at each follow-up. At the time of the last follow-up, seven patients had been lost: three were lost to contact, two died, and two were hospitalised elsewhere and unavailable for follow-up. The remaining 21 patients were followed for an average of 49.3 ± 15.4 (range: 24–74.4) months. Their average fracture healing time was 13.5 ± 1.1 (12–15.4) weeks. Complications included three cases (10.71%) of thrombus, one (3.57%) of heart failure, and one (3.57%) of pulmonary infection. There were no revisions due to prosthesis loosening, subsidence, or infection. At the last follow-up, the HHS, SF-36 mental score, and SF-36 physical score were recorded, LSRIF vs. ORIF (82.9 ± 6.6 vs. 74.7 ± 3.9, p = 0.059; 50.9 ± 7.6 vs. 38 ± 1.4, p = 0.012, and 51.7 ± 8.4 vs. 39.7 ± 3.4, p = 0.032, respectively). Specific UCS B2 fractures mostly occur with non-cemented stems. LSRIF with cables is the main treatment, while ORIF is an option for those elderly in poor condition.https://doi.org/10.1038/s41598-023-41698-x |
| spellingShingle | Wei-Qiang Zhao Xu-Song Li Meng-Qiang Fan Zhi-Yuan Yao Zhou-Feng Song Pei-Jian Tong Jie-Feng Huang Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures Scientific Reports |
| title | Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures |
| title_full | Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures |
| title_fullStr | Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures |
| title_full_unstemmed | Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures |
| title_short | Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures |
| title_sort | surgical treatment of specific unified classification system b fractures potentially destabilising lesser trochanter periprosthetic fractures |
| url | https://doi.org/10.1038/s41598-023-41698-x |
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