Management of type B2 and B3 post-operative proximal periprosthetic femoral fractures, Oghara experience

Abstract

Objective: To report the outcome of treatment of Types B2 and B3 Post- operative Periprosthetic proximal femoral fracture (PPFF) in four patients treated in Delta State University Teaching Hospital, Oghara, Delta State, using Vancouver classification of Duncan and Masri.
 Methodology: A retrospective study of four cases managed in this hospital. Information retrieved from case notes were sex, age, duration of prosthesis, treatment given, complications and outcome of treatment.
 Result: Atotal of 4 patients were reviewed in the study, 2 males and 2 females with a M: F of 1: 1. Duration of the implant before treatment was 5-12 years (mean of 8.3years). Age range was 60-83years (mean of 67.5 years). Two patients had Type B2 and two had Type B3. Average intraoperative blood loss was 1 litre. Duration of surgery was 3-4 hours. Duration of hospital stay was between 3 weeks and 5 months. The complications seen were primary haemorrhage, wound infection, hip dislocation and pulmonaryembolism. The outcome was good for 3 patients and fair in 1, using Harris Hip Score.
 Conclusion:Vancouver classification of Duncan and Masri is effective in the treatment of PPFF.
 Key words; Periprosthetic femoral fracture, Long stem hip prosthesis, Vancouver classification, osteolysis.

Treatment of Congenital Pseudarthrosis Tibia by Ilizarov Principle

“…Regarding demographic data, Enemudo et al [8] included five patients, predominantly males (2:3 ratio), aged 6 to 18 years (mean 11.6) with a mean leglength discrepancy (LLD) of 7.2 cm, reduced to zero post-treatment. All patients had unilateral limb involvement, café au lait spots, and were from lowincome backgrounds, with varied non-union types observed.…”

“…The study highlighted the lack of a universally applicable CPT classification that encompasses its pathological, clinical, and prognostic aspects. Enemudo et al [8] reviewed 18 CPT cases treated with the Ilizarov technique and intramedullary fixation, noting an average patient age of 6.2 years, with a gender distribution of 38.9% males and 61.1% females, and unilateral engagement with a slight preference for the left side (52.6%).…”

“…Preoperative gaps at the CPT site averaged 1.3 ± 1.0 cm, expanding to 6.1 ± 1.0 cm post-resection, with preoperative AOFAS scores ranging from 38-65. Enemudo et al [8] found that most patients had lower third involvement, were classified as Crawford type IV, with half showing fibula pseudarthrosis and a significant portion (72.2%) having NF1, and an average preoperative LLD of 3.2 cm. Four patients had undergone previous unsuccessful surgeries, while fourteen had no prior surgical attempts.…”

“…Additionally, proximal tibial valgus was noted in 12.1° on average, and LLD averaged 1.4 cm. Refractures occurred in 27.8% of patients, partly due to non-adherence to bracing instructions [8] .…”