Optimizing Proximal Fixation in Vancouver B1 Periprosthetic Femur Fractures

Vancouver B1 periprosthetic femur fractures present several challenges to the treating surgeon. Particularly difficult is achieving adequate fixation proximally in the presence of a femoral prosthesis and often poor bone quality. Standard screw fixation may not always be feasible, so often a combination of techniques must be used. Multiple fixation options exist without a consensus on the optimal fixation strategy. This article will review the literature and include radiographic case examples of several fixation strategies, including cerclage devices, screws, accessory plates, and double plating.