Periprosthetic Femur Fractures Treated With Modular Fluted, Tapered Stems
Bibliographic record
Abstract
BACKGROUND: Treatment of periprosthetic femur fractures is challenging, and high failure and complication rates have been reported in many series. The optimal techniques and implants for the management of Vancouver B2 and B3 fractures remain in debate. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the results of a relatively new class of femoral implants, uncemented fluted, tapered, modular stems, to treat periprosthetic femur fractures; we specifically evaluated (1) fracture union; (2) implant stability; (3) patient outcomes; and (4) complications. METHODS: We retrospectively identified 44 Vancouver B2 (25 patients) and B3 (19 patients) periprosthetic femur fractures treated consecutively with fluted, tapered stems at a single institution from 2000 to 2006. The mean patient age was 72 years (range, 34-92 years), and 24 were women. The minimum followup was 2 years (mean, 4.5 years; range, 2-8 years). RESULTS: Forty-three of 44 (98%) fractures healed radiographically and 43 of 44 (98%) femoral components were stable radiographically at latest followup. The mean postoperative Harris hip score was 83. There were seven additional reoperations (five for recurrent instability, two for deep infections). CONCLUSIONS: Modular fluted, tapered stems provide a reliable treatment method for Vancouver B2 and B3 periprosthetic femoral fractures with a high rate of fracture union and implant osteointegration. The most common complication, instability, may be reduced by more consistent use of larger femoral head diameters.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".