PMC10026097_01
Transverse vancouver B1 periprosthetic fracture
with cortical thickening.
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Radiographs revealed a periprosthetic non-comminuted transverse fracture with medial cortical thickening just distal to the tip of the stem (Figure 1).
Open reduction and internal fixation with NCB
periprosthetic femur plate system (Zimmer Biomet, Warsaw), cerclages and
medial cortical strut allograft.
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The patient underwent open reduction and internal fixation (ORIF) with NCB periprosthetic femur plate system (Zimmer Biomet, Warsaw), cerclages and medial cortical strut allograft (Figure 2).
Hardware failure 4 days after the
surgery.
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However, only after 4 days she sustained a hardware failure (Figure 3).
Reduction and fixation with a longer plate and a
longer cortical strut on the medial side.
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The patient underwent a new surgical open reduction and internal fixation with a longer plate augmented with a longer cortical strut on the medial side (Figure 4).
Refracture at the same level after 6 months of
partial weight bearing.
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Radiographic evaluation revealed breakage of the locking plate and a refracture at the same place (Figure 5).
Revision surgery with arcos modular femoral
revision stem interlocking 20 mm x 250 mm (Zimmer Biomet, Warsaw)
distally locked with 3 cortical screws.
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The ceramic head was replaced too with a 36 mm Biolox Delta (Figure 6).