A systematic review of open reduction and internal fixation of periprosthetic femur fractures with or without allograft strut, cerclage, and locked plates.

Few comparative studies exist for open reduction and internal fixation of Vancouver B1 and C fractures. We therefore performed a systematic review of fractures treated with or without an allograft strut, and using various fixation techniques. Thirty-seven manuscripts including 682 fractures were identified between 1992 and 2012. Percent union was similar for Vancouver B1 fractures treated with or without an allograft strut (90.7% vs. 91.5%). Time to union (4.4 vs. 6.6 months) and deep infection (3.8% vs. 8.3%) were increased with use of allograft struts. Percent union and time to union were unaffected by plate type or use of cerclage. We conclude that due to increased infection and time to union, allograft struts should be used cautiously during operative treatment of Vancouver B1 factures.