Periprosthetic Fracture Fixation in Ankylosing Spondylitis: A Surgical Challenge in a Stiffened Skeleton
Vol 06- Issue 1 | January 2025 | page: 26-29 | Soumitesh Sibananda Das, Nirmal Chandra Mohapatra, Rajesh Rana, Eshaan Mishra
DOI: https://doi.org/10.13107/ojot.2025.v06.i01.70
Received 01/04/2024; Reviewed 29/4/2024; Accepted 27/10/2024; Published 10/01/2025
Authors: Soumitesh Sibananda Das [1], Nirmal Chandra Mohapatra [1], Rajesh Rana [1], Eshaan Mishra [1]
[1] Department of Orthopaedics, Srirama Chandra Bhanja Medical College and Hospital,753007, Cuttack, Odisha, India
Address of Correspondence
Dr Soumitesh Sibananda Das,
Department of Orthopaedics, Srirama Chandra Bhanja Medical College and Hospital,753007, Cuttack, Odisha, India
Email: soumiteshdas@gmail.com
Abstract
Periprosthetic femoral fractures are challenging complications following total hip arthroplasty, especially in patients with ankylosing spondylitis due to altered biomechanics and compromised bone quality. We report a 37-year-old male with a history of bilateral total hip replacement (13 years prior) for ankylosed hips, who presented after a motorcycle fall with a right Vancouver type B1 periprosthetic femoral fracture. He was successfully managed with open reduction and internal fixation using a reversed contralateral distal femur anatomical locking plate augmented with cerclage wire. At six-month follow-up, the fracture had united, resulting in an excellent functional outcome. This case highlights the importance of accurate classification, stable fixation, and appropriate implant selection in complex periprosthetic settings.
Keywords: Periprosthetic fracture, Ankylosing spondylitis, Vancouver B1, Locking plate, Cerclage wire.
References
1. Chakravarthy J, Bansal R, Cooper J. Locking plate osteosynthesis for Vancouver type B1 and type C periprosthetic femoral fractures. Injury. 2007;38(6):725–33. PubMed
2. Brady OH, Garbuz DS, Masri BA, Duncan CP. Classification of periprosthetic femoral fractures. Orthop Clin North Am. 1999;30:235–47.
3. Lindahl H. Epidemiology of periprosthetic femur fracture around a total hip arthroplasty. Injury. 2007;38:651–4. SpringerLink
4. Kulkarni SL, Mannual S, Daragad M, Kumar A. Vancouver type B1 periprosthetic fracture managed with locked compression plate: a case report. Int J Case Rep Orthop. 2020;2(2):64–67. orthocasereports.com
5. Locking plate fixation for Vancouver B1 periprosthetic femoral fractures: a critical analysis. J Orthop Sci. 2013. PubMed
6. Rastogi D, Dwivedi MK, Singh S, Ullah SW. Management of Vancouver type B1 periprosthetic femoral shaft fracture using reversed contralateral distal femur locking plate. Natl J Clin Orthop. 2018. orthoresearchjournal.com
7. Distal femoral fractures: periprosthetic fractures have more complications; cerclage should be avoided. J Orthop Traumatol. 2024. SpringerLink
8. Outcomes of cemented and uncemented stem fixation in Vancouver B1 periprosthetic femur fractures treated with locking plates. J Orthop Surg Res. 2025. SpringerLink
9. Locking compression plate fixation of Vancouver type-B1 PFFs. PubMed. 2007. PubMed
10. Locking Plate Fixation of Periprosthetic Femur Fractures with and without Cerclage Wires. Orthop Surg. 2013.
| How to Cite this Article: Das SS, Mohapatra NC, Rana R, Mishra E. Periprosthetic Fracture Fixation in Ankylosing Spondylitis: A Surgical Challenge in a Stiffened Skeleton. The Odisha Journal of Orthopaedics and Trauma| January 2025; 06;01:26-29.
https://doi.org/10.13107/ojot.2025.v06.i01.70 |
