Retrospective series of 14 consecutive Vancouver type-B1 periprosthetic femoral fractures treated with locking compression plates (LCP), examining whether unicortical locking screw fixation provides adequate stability and whether cortical strut allograft supplementation affects outcomes. All fractures occurred after cemented THA; 11 were revision cases.
When you fix a Vancouver B1 fracture with a locking plate, don't rely on unicortical screws alone — the 43% failure rate here argues strongly for routine cortical strut allograft supplementation with cerclage wiring to prevent plate pullout and provide load-sharing stability.
In complex cases (revision THA, poor bone stock), also keep femoral component revision on the table even when the stem appears well-fixed.
Retrospective series of 14 consecutive Vancouver type-B1 periprosthetic femoral fractures treated with locking compression plates (LCP), examining whether unicortical locking screw fixation provides adequate stability and whether cortical strut allograft supplementation affects outcomes. All fractures occurred after cemented THA; 11 were revision cases.
When you fix a Vancouver B1 fracture with a locking plate, don't rely on unicortical screws alone — the 43% failure rate here argues strongly for routine cortical strut allograft supplementation with cerclage wiring to prevent plate pullout and provide load-sharing stability.
In complex cases (revision THA, poor bone stock), also keep femoral component revision on the table even when the stem appears well-fixed.