Management of Periprosthetic Femur Fractures

Total joint replacement (TJR) is among the most clinically successful reconstructive surgeries in orthopaedics. The incidence of periprosthetic femur fractures has increased for many reasons, including longer duration of in situ use of the TJRs, more active lifestyle, wear debris and associated osteolysis, and trauma. Moreover, the fracture may occur with the increasing volume of revision TJRs. These fractures pose a significant technical challenge to the surgeon. This review focuses on periprosthetic femur fractures around a total hip replacement. We have elected to emphasize the following issues:
• intraoperative calcar fractures from broaching and insertion of the stem during total hip replacement
• postoperative fractures as classified by the Vancouver system
• management and clinical outcome of treatment of these fractures