Abstract
Periprosthetic fractures of the femur: the stability of the implant dictates the type of treatment.
Highlights
The increasing incidence of complications after hip replacement surgery is a consequence of two main factors: the prolonged survival time in the general population and the increasing number of primary implants made worldwide in the last decades
The Vancouver classification of periprosthetic fractures of the hip [4, 5] is considered a reliable system for grading these fractures as well as for guiding treatment decisions
Fractures involving the trochanteric area are categorized as type A (Ag and Al for the greater and lesser trochanter, respectively), fractures about the stem or tip of the implant are type B, and fractures distal to the tip of the stem are type C
Summary
The increasing incidence of complications after hip replacement surgery is a consequence of two main factors: the prolonged survival time in the general population and the increasing number of primary implants made worldwide in the last decades. Posttraumatic fractures usually require operative treatment and are associated both with predisposing factors such as osteolysis, osteopenia and aseptic loosening of the implant as well as with determining factors such as minor traumatic events. Fixation of intraoperative fractures with wire cerclage or plates is effective, it is recommended to avoid such events through careful preoperative planning and optimal surgical technique.
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