Ortho-bridge system for the treatment of Vancouver type B1 periprosthetic femoral fractures based on three dimensional printing.

Objective: This study aims to evaluate the clinical outcomes of Vancouver B1 periprosthetic femoral fractures (PFF) treated with the Ortho-bridge system (OBS) internal fixation and assess the potential benefits of 3D printing technology in preoperative planning and surgical execution for these cases.

Method: This retrospective study analyzed 55 consecutive Vancouver B1 periprosthetic femoral fracture cases treated surgically at Yan'an Affiliated Hospital of Kunming Medical University (2014-2022) with minimum 1-year follow-up. Patients were divided into conventional ORIF (n = 21) and OBS fixation groups (n = 34), with the OBS group further stratified into standard procedure (n = 18) and 3D-printing-assisted (n = 16) subgroups. Treatment outcomes were evaluated using Harris Hip Scores, while surgical parameters including incision length, operative time, and intraoperative blood loss were compared between groups.

Result: The study included 55 Vancouver B1 PFF cases (ORIF = 21, OBS = 34), with the OBS group further divided into conventional (n = 18) and 3D-assisted (n = 16) subgroups. While no significant differences existed between ORIF and OBS groups in operative time (159.52 ± 56.35 vs. 165.03 ± 49.09 min), blood loss (734.29 ± 545.89 vs. 682.06 ± 341.88 mL), or incision length (22.62 ± 5.84 vs. 22.24 ± 6.72 cm), the 3D-assisted OBS subgroup demonstrated 18.6% shorter operative time (147.19 ± 39.54 vs. 180.89 ± 52.28 min, p < 0.05) and 26.0% reduced blood loss (575.00 ± 327.45 vs. 777.22 ± 334.52 mL, p < 0.05) compared to conventional OBS. All fractures healed (mean 4.78 months) with no revisions, though DVT occurred in two ORIF and two OBS cases. Functional outcomes were comparable across groups (Harris scores: ORIF 74.38 ± 9.39, OBS 74.18 ± 12.08; 3D-assisted OBS 75.31 ± 11.09 vs. conventional OBS 73.17 ± 13.13, p > 0.05).

Conclusion: The OBS internal fixation system demonstrates comparable efficacy to conventional ORIF for Vancouver B1 periprosthetic fractures, with equivalent functional outcomes and fracture healing rates. When combined with 3D-printing-assisted preoperative planning, OBS offers significant advantages including reduced operative time (18.6%) and decreased blood loss (26.0%). These findings suggest that the OBS system, particularly when enhanced by 3D printing technology, represents a viable alternative for PFF management, providing stable fixation while maintaining biological osteosynthesis principles.