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The purpose of this study is to compare two different but standard treatments for the fixation of Vancouver B1 periprosthetic. The investigators aim to compare open reduction internal fixation using a locked plating system versus plating and strut allograft with cerclage wiring to determine which treatment results in a faster return to function as measured by the TUG test at 6 weeks post-op.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cable plating with strut | Active Comparator | The plate will be placed laterally with the allograft strut placed on the anterior cortex. Screw fixation will be used distal to the stem and cables and screws will be used proximal to the stem tip. Cerclage cables or wires will be used to secure the strut. |
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| isolated plating | Active Comparator | A lateral thigh incision will be used to expose the fracture site. Surgeons will attempt to minimize devascularization of the bone by meticulous dissection and indirect reduction techniques. An appropriate sized plate will be applied to the lateral aspect of the femur. Fracture reduction will be achieved with the use of intra-operative fluoroscopy and the plate will be secured with locking screws. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Isolated Locked Compression Plate | Procedure | A lateral thigh incision will be used to expose the fracture site. Surgeons will attempt to minimize devascularization of the bone by meticulous dissection and indirect reduction techniques. An appropriate sized plate will be applied to the lateral aspect of the femur. Fracture reduction will be achieved with the use of intra-operative fluoroscopy and the plate will be secured with locking screws. |
| Measure | Description | Time Frame |
|---|---|---|
| TUG test score at 6 weeks post-op | We will administer the TUG test to each patient at 6 weeks to determine if there is a difference in functional status between both groups. | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Re-operation rates | We will measure rates of re-operationin each of the treatment groups on study specific case report forms. | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emil Schemitsch, MD, FRCS(C) | Contact | 416-864-6003 | schemitsche@smh.ca | |
| Michael McKee, MD, FRCS(C) | Contact | 416-864-5880 | mckeem@smh.ca |
| Name | Affiliation | Role |
|---|---|---|
| Emil Schemitsch, MD, FRCS(C) | Unity Health Toronto | Principal Investigator |
| Aaron Nauth, MD, FRCSC | Unity Health Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. michael's Hospital | Recruiting | Toronto | Ontario | M5C 1R1 | Canada |
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| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| ID | Term |
|---|---|
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D007869 | Leg Injuries |
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| Cable Plating and Strut Allograft with Cerclage Wiring | Procedure | The plate will be placed laterally with the allograft strut placed on the anterior cortex. Screw fixation will be used distal to the stem and cables and screws will be used proximal to the stem tip. Cerclage cables or wires will be used to secure the strut. |
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