ArticleJournal of orthopaedic surgery and research2020
Periprosthetic proximal femoral fractures in cemented and uncemented stems according to Vancouver classification: observation of a new fracture pattern.
Article in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- The race for the classification of proximal periprosthetic femoral fractures : Vancouver vs Unified Classification System (UCS) - a systematic review.BMC musculoskeletal disorders · 2022Pooled it
- Clinical outcome of periprosthetic femoral fractures: the influence of fracture pattern and patient specific risk factors.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Management of Clamshell Fractures in Total Hip Arthroplasty: A Rarely Recognized Periprosthetic Injury Pattern.Journal of clinical medicine · 2025Review
- Which B2 Fractures Can Be Treated with ORIF? Validation of the "Beyond the Vancouver Classification".Medicina (Kaunas, Lithuania) · 2025Article
- The Role of Osteoporosis in Total Hip Arthroplasty Periprosthetic Fractures and Current Management Strategies: a Review.Current osteoporosis reports · 2025Review
- Comparison of Clinical Outcomes of Periprosthetic Fractures Between Cemented vs Cementless Stem Methods After Initial Total Hip Arthroplasty or Bipolar Hemiarthroplasty: A Multicenter Analysis (TRON Study).Arthroplasty today · 2025Article
- Open reduction and internal fixation offers lower hip-related complications compared to stem revision in Vancouver B2 fractures around cemented polished tapered femoral stems.Journal of experimental orthopaedics · 2025Article
- The History of Classification Systems for Periprosthetic Femoral Fractures: A Literature Review.Orthopaedic surgery · 2024Article
- Comparative outcomes of uncemented and cemented stem revision in managing periprosthetic femoral fractures: a retrospective cohort study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- Optimizing periprosthetic fracture management and in-hospital outcome: insights from the PIPPAS multicentric study of 1387 cases in Spain.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Observational
- Article
- Locking plate for periprosthetic femoral fractures according to Vancouver C: Outcome and radiological subanalysis of 40 patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Surgical treatment of specific Unified Classification System B fractures: potentially destabilising lesser trochanter periprosthetic fractures.Scientific reports · 2023Article
- Revision total hip arthroplasty for periprosthetic fracture: epidemiology, outcomes, and factors associated with success.Annals of joint · 2023Review
- Comparison of Anterior and Lateral Approach in Hip Hemiarthroplasty for Femur Neck Fractures in the Elderly: Clinical and Radiographic Outcomes.Malaysian orthopaedic journal · 2022Article
- Periprosthetic Fracture around a Cemented Stem in Total Hip Arthroplasty.Hip & pelvis · 2022Review
- Treatment algorithm in Vancouver B2 periprosthetic hip fractures: osteosynthesis vs revision arthroplasty.EFORT open reviews · 2022Review
- [Perioperative management of ortho-geriatric knee or hip arthroplasty patients].Der Orthopade · 2022Review
- Treatment Algorithm of Periprosthetic Femoral Fracturens.Geriatric orthopaedic surgery & rehabilitation · 2022Review
- Risk Factors for Intraoperative Periprosthetic Femoral Fractures in Patients with Hip Dysplasia Undergoing Total Hip Arthroplasty with Uncemented Prostheses.Orthopaedic surgery · 2021Article
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeriprosthetic fractures are increasingly encountered in hip arthroplasty. The Vancouver classification system is widely used. Little knowledge exists regarding the association of the Vancouver classification with either cemented or uncemented stems. The aim was to analyse a series of fractures and determine associations.
methodsA series of consecutive patients over 8 years was identified including only post-operative fractures of primary hip arthroplasties. Baseline and radiographic characteristics were recorded including the type of stem fixation (cemented or uncemented) and Vancouver classification. Statistical analysis was performed to determine the association of the Vancouver classification between cemented and uncemented stems.
resultsA total of 172 patients were identified (84 cemented stems, 88 uncemented stems). There were 30 Vancouver A fractures (12 cemented vs.18 uncemented, p > 0.05), 125 Vancouver B fractures (63 cemented vs. 62 uncemented, p > 0.05) and 17 Vancouver C fractures (9 cemented vs. 8 uncemented, p > 0.05). The Vancouver B2 fracture occurred most frequently (N = 95; 44 cemented vs. 51 uncemented, p > 0.05) and consists of four distinct fracture patterns: the previously described comminuted 'burst', clamshell and spiral patterns and the newly observed 'reverse' clamshell. The burst and spiral fracture patterns are significantly associated with cemented stems, and the clamshell pattern is significantly associated with uncemented stems.
conclusionsVancouver A, B and C fractures occur equally in cemented and uncemented stems. Awareness of four distinct Vancouver B2 fracture patterns, including the newly observed reverse clamshell, will aid surgeons in predicting stem instability.
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