ArticleArchives of orthopaedic and trauma surgery2025
Revision arthroplasty versus open reduction and internal fixation in Vancouver type B2 and B3 periprosthetic femoral fractures: results from a matched pairs analysis of the registry for geriatric trauma of the DGU
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Managing Vancouver B2 periprosthetic femoral fractures: is open reduction and internal fixation superior to stem revision? : A comparative analysis with a minimum 5-year follow-up.Archives of orthopaedic and trauma surgery · 2026Article
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9 authors.
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Abstract
BACKGROUND AND
objectivesOwing to a lack of evidence, the appropriate surgical treatment strategy for geriatric patients with Vancouver type B2 or B3 periprosthetic femoral fractures (PFFs) remains unclear. Data from a large international geriatric trauma registry were analyzed to investigate the medical care situation of such patients, as well as to examine the outcomes related to revision arthroplasty (RA) or open reduction and internal fixation (ORIF). MATERIALS AND
methodsDatasets from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie [DGU]) (ATR-DGU) were analyzed. The ATR-DGU is a prospective, multicenter registry that provides information on geriatric trauma patients. All patients who underwent surgery for PFF were included in this analysis. The outcome parameters included the mortality rate during hospitalization and at the 120-day follow-up, as well as mobility, the EQ-5D-5 L score and the reoperation rate, and were analyzed in relation to RA versus ORIF in Vancouver type B2 or B3 PFF patients.
resultsA total of 607 patients with Vancouver type B2 or B3 PFF met the inclusion criteria. Among these patients, 420 underwent RA, and ORIF was performed in 187 patients. Regression analysis of the parameters collected during the acute phase revealed that after 2:1 matching, compared with the RA group, the ORIF group had significantly lower odds for full weight bearing allowed one day after surgery (OR: 0.49; p < 0.001); walking ability after seven days (OR: 0.56; p = 0.005); and the occurrence of nonsurgical complications (OR: 0.59; p = 0.012). The probability of death during follow-up and the EQ-5D-5 L score after seven and 120 days remained unaffected.
conclusionsThe results of the present study support the estimate that ORIF represents a valid treatment alternative for Vancouver type B2 and B3 PFFs, as comparable midterm outcomes were demonstrated for each patient group. However, individualized decisions should always be made, especially for multimorbid geriatric patients, to reduce complications.
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