Similar Surgical Outcome between Locking Plate versus Nonlocking Plate Fixation for Postoperative Vancouver Type B1 Periprosthetic Femur Fractures: A Retrospective Cohort Study
Bibliographic record
Abstract
Background: Periprosthetic femur fractures (PFF) after total hip arthroplasty, particularly Vancouver type B1 fractures, can result from a variety of factors and pose challenges for orthopedic surgeons. The optimal fixation method for these fractures remains a topic of debate, with conflicting evidence regarding the outcomes of locking versus nonlocking plate fixation. Objectives: We aim to compare the outcomes of locking plate fixation versus nonlocking plate fixation for the treatment of postoperative Vancouver type B1 PFF with our experiences. Materials and Methods: This study utilized a retrospective cohort design to compare the outcomes of locking plate fixation versus nonlocking plate fixation for the treatment of Vancouver type B1 PFF. Patients who had received osteosynthesis for Vancouver type B1 PFF around hip arthroplasty from 2011 to 2020 were identified as the study participants. The inclusion criteria included osteosynthesis with conventional nonlocking or locking mechanism plating performed for surgical treatment for an acute, traumatic Vancouver type B1 PFF around hip arthroplasty. Data were collected through a review of medical records, operative reports, and imaging studies of the patients. All fractures were treated with open reduction and internal fixation with conventional and locking plating methods. Results: The study population consisted of 25 patients, with 14 patients receiving conventional plating and 11 patients receiving locking plating. The revision rate and union rate were not significantly different between the two groups. There were no instances of stem subsidence in either group. Only one case in the conventional group suffered from nonunion and required secondary surgery. Conclusions: No significant differences were observed in the revision rate or union rate between locking plate fixation and conventional nonlocking plate fixation for Vancouver type B1 PFF in this study. These findings suggest that achieving proper reduction and utilizing a sufficient plate length are key factors for successful bone union, regardless of the plate design used.
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| 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 | 0.000 |
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".