Yang Huiqin, Mithu Md Miftahul, Xin Xin, Wang Zhongxin, Duan Weiyu, Lu Chengbin, Xu Benmo, Huang Jiazheng, Ren Yunfeng, Wu Zhongxiong, Pu Qi, Yang Hongkun, Lu Jipeng, Xiong Ying, Chen Zhuoyuan, Yang Fang
Department of Orthopedics, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, 650051, Yunnan, P. R. China.
Institute of Neuroscience, Kunming Medical University, Kunming, 650500, China.
Int Orthop. 2025 Sep 6. doi: 10.1007/s00264-025-06648-4.
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.
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.
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).
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.
本研究旨在评估采用奥索桥系统（OBS）内固定治疗温哥华B1型股骨假体周围骨折（PFF）的临床疗效，并评估3D打印技术在这些病例的术前规划和手术实施中的潜在益处。
这项回顾性研究分析了昆明医科大学延安附属医院（2014年至2022年）手术治疗的55例连续的温哥华B1型股骨假体周围骨折病例，随访时间至少1年。患者分为传统切开复位内固定（ORIF）组（n = 21）和OBS固定组（n = 34），OBS组进一步分为标准手术组（n = 18）和3D打印辅助组（n = 16）。使用Harris髋关节评分评估治疗效果，同时比较各组之间的手术参数，包括切口长度、手术时间和术中出血量。
该研究纳入了55例温哥华B1型PFF病例（ORIF = 21例，OBS = 34例），OBS组进一步分为传统组（n = 18）和3D辅助组（n = 16）。虽然ORIF组和OBS组在手术时间（159.52 ± 56.35对165.03 ± 49.09分钟）、出血量（734.29 ± 545.89对682.06 ± 341.88毫升）或切口长度（22.62 ± 5.84对22.24 ± 6.72厘米）方面无显著差异，但与传统OBS组相比，3D辅助OBS亚组的手术时间缩短了18.6%（147.19 ± 39.54对180.89 ± 52.28分钟，p < 0.05），出血量减少了26.0%（575.00 ± 327.45对777.22 ± 334.52毫升，p < 0.05）。所有骨折均愈合（平均4.78个月），无翻修病例，不过ORIF组和OBS组各有2例发生深静脉血栓形成。各组功能结果相当（Harris评分：ORIF组74.38 ± 9.39，OBS组74.18 ± 12.08；3D辅助OBS组75.31 ± 11.09对传统OBS组73.17 ± 13.13，p > 0.05）。
OBS内固定系统在治疗温哥华B1型假体周围骨折方面显示出与传统ORIF相当的疗效，功能结果和骨折愈合率相当。当与3D打印辅助的术前规划相结合时，OBS具有显著优势，包括手术时间缩短（18.6%）和出血量减少（26.0%）。这些发现表明，OBS系统，特别是在3D打印技术的辅助下，是PFF治疗的一种可行替代方案，在维持生物学骨愈合原则的同时提供稳定固定。
