Failure of Nonoperative Treatment of a Vancouver B2 Periprosthetic Fracture About an Antibiotic Spacer.

Few case reports have been published describing the management of periprosthetic femur fractures with an antibiotic spacer. We report a case of a 58-year-old female who sustained a Vancouver B2 femur fracture with an antibiotic spacer that was initially treated with nonoperative measures. However, she went on to have increased fracture displacement and subsidence warranting operative intervention in the form of conversion to total hip arthroplasty with a diaphyseal fitting spline tapered stem and open reduction and internal fixation of the femur. We suggest that periprosthetic fractures about antibiotic spacers may be at a higher risk of displacement due to a lack of stem ingrowth potential and that early operative management may be more appropriate for these patients.