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Stem Revision in Periprosthetic Fractures

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Femoral Revision Arthroplasty

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Abstract

Periprosthetic fractures of the femur require stem revision when the stem is loosened (Vancouver types B2 and B3 fractures) or the stem of the prosthesis is broken at the same time. In my opinion, it is also recommended as a procedural change in cases of failed plate osteosynthesis of a Vancouver type B1 fracture (with a firmly fixed stem). In this case, the exchange should be made to a cementless revision stem, whereby the new stem must be fixed below the fracture in the femur. In order to be able to perform this reliably, the proximal fragment should be accessed via a transfemoral approach (extended trochanteric osteotomy). If the isthmus is still intact (Vancouver type B2 fractures), this serves as the fixation site; if the isthmus is not intact (Vancouver type B3 fractures), additional fixation procedures such as distal interlocking are required. This chapter discusses the different surgical procedures involved.

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Authors and Affiliations

  1. Orthopaedic Clinic Markgröningen, Markgröningen, Baden-Württemberg, Germany

    Bernd Fink

  2. Orthopaedic Department, University-Hospital Hamburg-Eppendorf, Hamburg, Germany

    Bernd Fink

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  1. Bernd Fink
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Correspondence to Bernd Fink .

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Fink, B. (2022). Stem Revision in Periprosthetic Fractures. In: Femoral Revision Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-030-84821-7_18

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  • DOI: https://doi.org/10.1007/978-3-030-84821-7_18

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  • Online ISBN: 978-3-030-84821-7

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