Vancouver Type B2 Fractures

Description

Professor Dominic Meek gives his expert insights and details the management of an elderly patient who has fallen and is diagnosed with a Vancouver B2 fracture associated with an uncemented total hip replacement. He emphasizes that a B2 fracture typically indicates a loose implant, which can only be truly assessed during surgery. Professor Meek suggests that internal fixation is generally ineffective for loose uncemented stems since the implant will remain loose, and revision arthroplasty is the recommended surgical approach to address both the fracture reduction and implant stability. The approach may involve using a tapered stem to secure good cortical bone distally, as well as considerations regarding cemented versus uncemented stems, particularly common in the UK. For cemented stems, there may be potential to avoid revision by properly reducing the proximal femur to reposition the cement. Overall, this information outlines the surgical decision-making process for hip fractures in elderly patients and the implications of differing implant types on treatment strategies.


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DOI: 10.1302/3114-251270

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