O2275 IMPACTION GRAFTING REVISION IN THE MANAGEMENT OF PERIPROSTHETIC FEMORAL FRACTURES

Abstract

Aim: To assess the outcome of periprosthetic femoral fractures (Vancouver B2 and B3 types) around loose stems treated by impaction grafting revision. Methods: 72 patients with fractures around loose implants were reviewed. Two groups of patients were identiþed; in group one 14 patients were treated with revision of the femoral component to a sort stem (lying entirely above the most distal fracture line) and impaction grafting; in group two 58 patients were treated with revision of the femoral component to a long stem (bypassing the most distal fracture line by at least the length of two ipsilateral femoral diameters) and impaction grafting. The patients were followed up for a year and outcome was assessed clinically and radiologically. Results: 49 out of 58 fractures (84.48%) in group two patients, united within an average time of 7.44 months, and 9 (15.51%) failed to unite and required further surgery. 8 out of 14 fractures (57.14%) in group one patients subsequently healed in an average time of 5.62 months, whereas 6 (42.8%) failed to heal. Conclusion: Impaction grafting is an increasingly popular technique for the restoration of femoral bone stock. It can successfully be applied to periprosthetic femoral fractures but a long stem should be used and the fracture line should be bypassed by two cortical diameters.