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Re: Вопрос по лечению перипротезного перелома бедр
послал Marco Berlusconi 14 Апрель 2007, 09:34
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Dear Sirs,
according to the Vancouver classification thi looks like a B1 type so ORIF is indicated.
This kind of plate is "forbidden" in literature because has bad results with failure at 1 or 2 months.
The correct ORIF is with a LCP system with a good fixation either proximally or distally (longer than this one).
I think that in this case I'll add also bone graft because that plate damage the bone under the plate.
But my question is another.
Is the Vancouver classification yet correct ?
In German literature a lot of Authors says that in any case of periprosthetic fracture the energy of trauma causes a damage to the stability of the stem, so, in any case of B fracture is suggested a longer stem.
In our Institution we apply the Vancouver protocol with LCP as ORIF, but we realize that the healing of these fractures is quite long (6 months and
over) often in old patients. Perhaps the changing of the stem could be a faster way to help these patients.
Comments?
Best regards
Marco Berlusconi
Trauma Unit
Istituto Clinico Humanitas
Milan Italy
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