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Case Reports
. 2023;11(11):717-720.
doi: 10.22038/ABJS.2023.71540.3342.

A Rare Case of Open (Gustilo II) Periprosthetic Fracture (Vancouver B2) in a Polytraumatized Patient

Giorgio Cacciola  1   2 , Danilo Colombero  3 , Enrico Bellato  1   2
Affiliations
Case Reports

A Rare Case of Open (Gustilo II) Periprosthetic Fracture (Vancouver B2) in a Polytraumatized Patient

Giorgio Cacciola et al. Arch Bone Jt Surg. 2023.

Abstract

Periprosthetic femoral fracture is the third most frequent complication after total hip replacement (THR). It is mainly caused by low-energy trauma in the elderly. Open periprosthetic fractures are significantly rarer and are caused by high-energy trauma. Here we present a case of a 73-year-old man who sustained an open (Gustilo II) left periprosthetic femoral fracture with an unstable femoral component (Vancouver B2). After an early stabilization with a temporary external fixator, a single-stage revision using a tapered long femoral stem was performed. At the last follow-up (3.2 years), the patient was satisfied and walked without pain and aids, and the Harris Hip Score was 83.5. No signs of infection or osteolysis were present in the last radiographs.

Keywords: Open periprosthetic fracture; Periprosthetic fracture; Polytruma; Vancouver classification.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(A) Open femoral fracture 4 cm laceration, (Gustilo II) involving the left thigh; (B) AP view of the left femur demonstrating a Vancouver B2 periprosthetic fracture
Figure 2
Figure 2
(A) Early stabilization of the fracture with external fixation and (B) postoperative x-ray
Figure 3
Figure 3
Radiographic anteroposterior (A) and axial view (B) at three months of follow-up showing the partial healing at the fracture site, the adequate position of the implant, and no signs of migration
Figure 4
Figure 4
Radiographic anteroposterior (A) and axial view (B) at 3.2 years of follow-up showing the complete fracture healing, the good position of the acetabular component, and subsidence of the femoral stem without progressive radiolucent lines
See this image and copyright information in PMC

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