Vancouver B2 and B3 periprosthetic femoral fractures treated by ORIF. Mid to long-term follow-up study in 28 patients.
Bibliographic record
Abstract
OBJECTIVE: Periprosthetic femoral fractures (PFF) are a serious complication in patients who have undergone hip arthroplasty. Some authors consider revision arthroplasty as the gold standard in the surgical treatment of Vancouver type B2 and B3 PFF. Others, however, prefer treating PFF by open reduction and internal fixation (ORIF), without revising loose stems, especially in elderly patients. In the present retrospective study, we report mid/long-term results in a series of patients affected by B2 or B3 PFF surgically treated by ORIF, using a locking compression plate (LCP), thus avoiding the need of revision arthroplasty. MATERIALS AND METHODS: We reviewed 28 patients affected by B2 or B3 PFF surgically treated between 2010 and 2017 by ORIF using a LCP, after an average follow-up of 5.5 years. The average age of the patients at diagnosis was 78 years; in 17 patients, the femoral stem was uncemented while in 11, cemented. The mean interval time between hip arthroplasty and PFF was 6.7 years. Clinical results were assessed using Harris Hip Score (HHS), while radiographic results according to Beals and Tower criteria. RESULTS: At follow-up, HHS ranged from 72 to 96 points; 8 patients had an excellent result, 12 got a good result and 8 a fair result. According to Beals and Tower criteria, all the radiographic results were excellent (9 patients) or good (19 patients). The majority of our patients returned to their previous ambulatory levels. CONCLUSIONS: According to our results, in elderly patients affected by Vancouver type B2 or B3 PFF, surgical treatment by ORIF using a locking compression plate, without a stem revision, seems to be associated with satisfactory outcome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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 source (direct Gemma or distilled Codex), 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".