Letters about Published Papers

Re: Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study. J Orthopaedic Surgery, published May–Aug 27(2). DOI: 10.1177/2309499019857653.

To the editor

We read with interest the paper by Wang et al. ¹ However, there is a different view of the fracture type in Figure 2. We think that this is Vancouver type B1 fracture, rather than the type B2. Baba classification ² also suggests the stem of this type of fracture is stable, which supports our view. So, it does not need longer stem revision, but open reduction and internal fixation. Of course, longer stem revision for type B1 fractures can also achieve satisfactory results, but the operation trauma will be larger than that of open reduction and internal fixation.

The shortcomings of Vancouver Classification System ³ and the Unified Classification System ⁴ lie in that, according to imaging examination, the difference of the stability of the stem often depends on the subjective judgment of doctors. ⁵ Of course, the ultimate stability of the stem is determined by the specific conditions in the operation.