IntroductionPeriprosthetic femoral fracture around hip arthroplasty are growing in the world, nevertheless management and treatment options for fractures “around the stem” are still debated due to lack of high-level studies.Materials and methodA 85-item survey were fill out by 40 Italian Orthopedic Surgeon member of SIOT (Società Italiana di Ortopedia e Traumatologia) and AIR (Associazione Italiana Riprotesizzazione) to assess their current opinion in the management of type B periprosthetic femoral fractures. Responses were summarized using proportions, and further stratified by practice type, case volume, surgeon age, and fellowship training.ResultsVancouver/UCS fracture classification showed a good interobserver agreement (k value = .76). ORIF were the treatment of choice for UCS type B1 fractures (100%), revision stem for B2 (85%) and B3 (100%). Locked plates were preferred to cable plate and cerclage without a plate for B1 fractures (50% vs 40% vs 10%); revision with modular stem was preferred to monoblock stem for B2 fractures (50% vs 35%) and B3 (75% vs 15%). Responders tended to postpone at 1-month weight-bearing in patients with B1 fractures. Regarding postoperative pharmacological treatment there was absolute lack of consensus.DiscussionThe primary finding of our survey confirmed the preference of ORIF for B1 fractures and stem revision for B2 and B3 fractures. However, there is no definitive operative technique for all UCS B fractures. Surgeons tended to favor locked plating over cable plating, although only slightly. This general lack of consensus coincides with the inconclusive evidence that currently exists in the literature, which demonstrates both favorable and unfavorable outcomes for both techniquesConclusionsThe absence of complete homogeneity among participants showed the need for prospective randomized studies to set up stronger guidelines for classification, management, surgical treatment, rehabilitation, and pharmacological support of periprosthetic femoral fractures.

中文翻译：

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意大利翻修外科协会会员治疗统一分类系统 B 型髋关节置换术周围股骨假体周围骨折的当前实践：横断面调查

简介 髋关节置换术周围股骨假体骨折在世界范围内呈增长趋势，但由于缺乏高水平的研究，“股骨柄周围”骨折的管理和治疗方案仍存在争议。材料和方法由 40 位意大利骨科医师填写了 85 项调查SIOT (Società Italiana di Ortopedia e Traumatologia) 和 AIR (Associazione Italiana Riprotesizzazione) 的外科医生成员评估他们目前对 B 型假体周围股骨骨折的治疗意见。使用比例总结反应，并根据实践类型、病例数量、外科医生年龄和奖学金培训进一步分层。结果温哥华/UCS 骨折分类显示出良好的观察者间一致性（k 值 = .76）。ORIF 是 UCS B1 型骨折 (100%) 的首选治疗方法，B2 (85%) 和 B3 (100%) 的翻修柄。对于 B1 骨折，锁定钢板优于电缆钢板和无钢板环扎（50% vs 40% vs 10%）；对于 B2 骨折（50% 对 35%）和 B3 骨折（75% 对 15%），使用模块化假体进行翻修优于单块假体。对于 B1 骨折患者，响应者倾向于推迟 1 个月的负重。关于术后药物治疗完全缺乏共识。讨论我们调查的主要发现证实了 ORIF 对 B1 骨折的偏好和对 B2 和 B3 骨折的假体翻修的偏好。然而，对于所有 UCS B 骨折没有明确的手术技术。外科医生倾向于锁定电镀而不是电缆电镀，尽管只是轻微的。这种普遍缺乏共识与文献中目前存在的不确定证据相吻合，