Pablo Castillón, J. M. Muñoz Vives, H. Aguado, Arantxa Capel Agundez, Alina Ortega-Briones, Jorge Hassan Núñez, _, Agathe Guenego, H. Aguado, Samer Amhaz, Miguel Aroca, Pedro Caba, Arantxa Capel, Pablo Castillón, Santiago Gallardo, Miguel Ángel Giraldez, Vicente Guimera, José Manuel Martínez, J. Muñoz, Carlos Olaya, Alina Ortega, Eudald Romero, Raquel Ruíz, J. Salvador, José Carlos Saló, Jordi Selga, J. Teixidór, Jordi Tomás, Miquel Videla, José Ramón Pérez del Valle
{"title":"Consensus review on peri-implant femur fracture treatment: Peri-Implant Spanish Consensus (PISCO) investigators’ recommendations","authors":"Pablo Castillón, J. M. Muñoz Vives, H. Aguado, Arantxa Capel Agundez, Alina Ortega-Briones, Jorge Hassan Núñez, _, Agathe Guenego, H. Aguado, Samer Amhaz, Miguel Aroca, Pedro Caba, Arantxa Capel, Pablo Castillón, Santiago Gallardo, Miguel Ángel Giraldez, Vicente Guimera, José Manuel Martínez, J. Muñoz, Carlos Olaya, Alina Ortega, Eudald Romero, Raquel Ruíz, J. Salvador, José Carlos Saló, Jordi Selga, J. Teixidór, Jordi Tomás, Miquel Videla, José Ramón Pérez del Valle","doi":"10.1530/eor-23-0105","DOIUrl":null,"url":null,"abstract":"\n\n\nA peri-implant femoral fracture (PIFF) is defined as a femoral fracture in the presence of a pre-existing non-prosthetic implant. Classification systems, treatment guidelines and fixation strategies exist for peri-prosthetic fractures, but there is no standard of care regarding PIFFs.\n\n\nThe aim of the Peri-Implant Spanish Consensus (aka PISCO) investigators is to reach an agreement regarding current practices for management of PIFFs and to propose four main principles to assess surgical treatment and prevention of these fractures.\n\n\nThis consensus review was conducted according to the Delphi method. Twenty-two expert orthopaedic trauma surgeons performed the consensus and the definitive statements were approved unanimously.\n\n\nBiological fixation principles must be utilized in the surgical treatment of peri-implant femur fractures, which include closed or minimally invasive reduction techniques. The osteosynthesis must protect the entire bone.\n\n\nGaps between two implants should be avoided. If implant overlap is not possible to achieve, then spanning inter-implant fixation systems must be used, especially in osteoporotic bone.\n\n\nPrevious implants should be retained during surgical treatment of peri-implant femur fractures. Only those implants that would interfere with current fixation goals should be removed.\n\n\nIf the previous implant is in the femoral neck region, then femoral neck protection must be maintained when treating the peri-implant fracture, even if the neck fracture has already healed.\n\n","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Efort Open Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1530/eor-23-0105","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
A peri-implant femoral fracture (PIFF) is defined as a femoral fracture in the presence of a pre-existing non-prosthetic implant. Classification systems, treatment guidelines and fixation strategies exist for peri-prosthetic fractures, but there is no standard of care regarding PIFFs.
The aim of the Peri-Implant Spanish Consensus (aka PISCO) investigators is to reach an agreement regarding current practices for management of PIFFs and to propose four main principles to assess surgical treatment and prevention of these fractures.
This consensus review was conducted according to the Delphi method. Twenty-two expert orthopaedic trauma surgeons performed the consensus and the definitive statements were approved unanimously.
Biological fixation principles must be utilized in the surgical treatment of peri-implant femur fractures, which include closed or minimally invasive reduction techniques. The osteosynthesis must protect the entire bone.
Gaps between two implants should be avoided. If implant overlap is not possible to achieve, then spanning inter-implant fixation systems must be used, especially in osteoporotic bone.
Previous implants should be retained during surgical treatment of peri-implant femur fractures. Only those implants that would interfere with current fixation goals should be removed.
If the previous implant is in the femoral neck region, then femoral neck protection must be maintained when treating the peri-implant fracture, even if the neck fracture has already healed.
期刊介绍:
EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity.
This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances.
One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress.
EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.