RT info:eu-repo/semantics/article
T1 Internal fixation versus revision arthroplasty for Vancouver B2–B3 fractures: mortality and functional outcomes in frail patients. Insights from the PIPPAS study of 485 patients
A1 Moreta, Jesús
A1 Aguado, Héctor J.
A1 Castillón-Bernal, Pablo
A1 Muñoz-Vives, Josep M.
A1 Camacho, Pilar
A1 Jornet-Gibert, Montsant
A1 Teixidor, Jordi
A1 Pereda-Manso, Adela
A1 García-Sánchez, Yaiza
A1 Ojeda-Thies, Cristina
A1 García-Portabella, Pablo
A1 Álvarez, Elvira Mateos
A1 Noriega-González, David
A1 Muñoz-Moreno, María-Fe
A1 Arroyo-Hernantes, Irene
A1 Álvarez-Ramos, Begoña Aránzazu
A1 García-Medrano, Belén
A1 Martínez-Sellés, Carmen
A1 Marín-Jiménez, Sergio
A1 García-Virto, Virginia
A1 País-Ortega, Sergio
A1 Acha, Adriana
A1 Tomás-Hernández, Jordi
A1 Selga-Marsà, Jordi
A1 Andrés-Peiró, José Vicente
A1 Piedra-Calle, Carlos
A1 Blasco-Casado, Ferrán
A1 Guerra-Farfán, Ernesto
A1 Querolt-Coll, Jordi
A1 de Santamaría, Guillermo Triana-López
A1 Hernández, José M.
A1 Renau-Cerrillo, Marina
A1 Gil-Aliberas, Carles
A1 Carreras-Castañer, Anna
A1 Vives-Barquiel, Marian
A1 Fernández, Eliam Ajuria
A1 Manzano, Eugenia Fernández
A1 De Cortázar, Unai García
A1 Arrieta, Mirentxu
A1 Escobar, Daniel
A1 Castrillo, Estíbaliz
A1 Balvis Balvis, Patricia
A1 Denisiuk, Maciej
A1 Menéndez, Manuel Castro
A1 Pastor, Sonsoles
A1 Larrazábal, Ane
A1 Olías-López, Beatriz
A1 Amaya-Espinosa, Patricia
A1 Boluda-Mengod, Juan
A1 González-Martín, David
A1 López-Dorado, Daniel
A1 Borrás-Cebrián, Juan Carlos
A1 Martínez-Pérez, Carles
A1 Pazmiño, Patricio Andrés Freile
A1 Calavia-Calé, Pablo
A1 Suárez-Suárez, Miguel Ángel
A1 Lanuza-Lagunilla, Lucía
A1 Arias, Antonio García
A1 Cabria-Fernández, Julián
A1 García-Coiradas, Javier
A1 Valle-Cruz, José
A1 del Saz, Jaime Sánchez
A1 Mora-Fernández, Jesús
A1 Lalueza-Andreu, Pedro
A1 Bonome-Roel, César
A1 Cano-Leira, María Ángeles
A1 Carrasco, Antonio Benjumea
A1 Pariza, Ana López-de
A1 Fernández-Juan, Alexis
A1 la Puente, Carmen Sevillano-de
A1 Juldain-Mondragón, Miren
A1 Arsuaga, Jorge Guadilla
A1 Saura-Sánchez, Eladio
A1 Giménez-Ibáñez, Sandra
A1 Sánchez-Gómez, Plácido
A1 Ricón-Recarey, F. Javier
A1 García García, Elena M.
A1 Cuadrado-Abajo, Francisco
A1 Pérez-Núñez, María Isabel
A1 del Pozo-Manrique, Pedro
A1 Navas-García, Francisco Manuel García
A1 García-Paredero, Ester
A1 Guijarro-Valtueña, Ainhoa
A1 Robles, Teresa Beteta
A1 Navas-Pernía, Inés
A1 De Villasante-Jirón, Ignasi
A1 Porta, Teresa Serra
A1 Becerra, Carmen Carrasco
A1 Otero-Naveiro, Víctor
A1 Paz, Silvia Pena
A1 Castrillo, Inés Fernández-Billón
A1 Fernández-Dorado, Fátima
A1 Martínez-Menduiña, Amaia
A1 Vaquerizo-García, Víctor
A1 Murcia-Asensio, Antonio
A1 Galián-Muñoz, Elena
A1 Marín-Martínez, Carmelo
A1 Muñoz-Vicente, Adrián
A1 Plaza-Salazar, Nuria
A1 Gámez-Asunción, Carla
A1 Benito-Santamaría, Jennifer
A1 Salgado-Tarrida, Paula
A1 Prats-Puente, Oriol
A1 Cuenca-Copete, Alejandro
A1 González-Montero, Blas
A1 Giraldo-Vegas, Luis Alejandro
A1 Mingo-Robinet, Juan
A1 Briso-Montiano, Ricardo
A1 Barbería-Biurrun, Amaya
A1 Escudero-Martínez, Emma
A1 Chouza-Montero, Laura
A1 Naharro-Tobío, María
A1 Gasset-Teixidor, Alfons
A1 Domínguez-Ibarrola, Andrea
A1 Peñalver, J. M.
A1 Serrano-Sanz, Jorge
A1 Roche-Albero, Adrián
A1 Martín-Hernández, Carlos
A1 Macho-Mier, María
A1 Saló-Cuenca, José Carlos
A1 Roselló, Jordi Espona
A1 Criado-Albillos, Guillermo
A1 Cabello-Benavides, Hugo Gabriel
A1 Nestar, David Alonso
A1 González-Bernal, Jerónimo
A1 González-Santos, Josefa
A1 Cunchillos-Pascual, Jorge
A1 Blasco, Jorge Martínez-Íñiguez
A1 Bogallo-Dorado, José Manuel
A1 Ramírez-Roldán, Alicia
A1 Cano-Porras, Juan Ramón
A1 Marqués-López, Fernando
A1 Martínez-Díaz, Santos
A1 Slullitel, Pablo I.
A1 Carabelli, Guido S.
A1 Astore, Ignacio
A1 Boietti, Bruno Rafael
A1 Córdova-Peralta, Julio César
A1 Hernández-Pascual, Carlos
A1 Rodríguez-Gangoso, Alfredo
A1 Dot-Pascuet, Iván
A1 Piñeiro-Borrero, Ana
A1 Pérez-Sánchez, José María
A1 Mandía-Martínez, Alfonso
A1 De Caso-Rodríguez, Julio
A1 Martín-Marcuello, Jordi
A1 Benito-Mateo, Miguel
A1 Alda-Gastiain, Oiane
A1 Corcuera-Elosegui, Irene
A1 González-Panisello, María Rosa
A1 Pérez-Salazar, Nicolás Elizalde
A1 De Sande-Díaz, María
K1 Periprosthetic fracture
K1 Orthogeriatrics
K1 Vancouver B2 fracture
K1 Vancouver B3
K1 Mortality
K1 Revision
K1 Fixation
K1 Frailty
K1 Weight-bearing
K1 Total hip arthroplasty
AB BackgroundPeriprosthetic femoral fractures following hip arthroplasty (FH-PPF) represent a severe complication, especially in elderly patients with compromised health. Traditionally, revision arthroplasty is recommended for B2–B3 FH-PPF, yet internal fixation has emerged as a debated alternative in select patients. The hypothesis was that fixation, in selected patients with B2–B3 FH-PPF, decreases mortality and surgical complication rates with the same functional outcomes as revision arthroplasty.Materials and methodsPIPPAS is a multicenter prospective observational study. This cohort substudy includes 485 patients across 57 hospitals with B2–B3 FH-PPF between January 2021 and May 2023. Management strategy, revision or fixation, was at the attending surgeon’s discretion. Propensity score matching, controlled for age, age-adjusted Charlson Comorbidity Index (a-CCI), prefracture mobility, Pfeiffer scale, and ASA score, was done. Mortality risk factors were assessed using univariate and multivariate analysis.ResultsOut of 485 patients, 164 received fixation, and 321 underwent revision. Fixation patients were older (88 versus 82 years, p < 0.001) and frailer. Fixation was associated with shorter hospital stay (13 versus 15 days, p = 0.003) but higher 1-year mortality (25% versus 14.3%, p = 0.04). There were no differences in medical or surgical complications (p = 0.83 and p = 0.36) at any time, but dislocation rate was higher in the revision group (p = 0.001). The 1-year mortality rate in patients with no weight-bearing restrictions was higher for the revision group (p = 0.01). The propensity score matching showed higher 1-year mortality rate in the fixation group but no differences in functional outcomes, complications, or up to 6-months mortality. In the multivariate analysis a-CCI, cognitive impairment, B3 fractures, and prefracture independent walking impairment were independent mortality risk factors.ConclusionsRevision arthroplasty showed less 1-year mortality rate and weight-bearing restrictions than fixation. However, frail patients with B2–B3 FH-PPF managed with fixation allowing full weight-bearing showed a lower 1-year mortality rate. Fixation in B2–B3 FH-PPF is a treatment option in frail patients, while aiming for stable constructions allowing full weight-bearing.
PB Springer
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/81221
UL https://uvadoc.uva.es/handle/10324/81221
LA eng
NO J Orthop Traumatol. 2025 Dec 22;26(1):78.
NO Producción Científica
DS UVaDOC
RD 11-ene-2026