Principles Of Treatment For Periprosthetic Femoral Fractures After Total Hip Arthroplasty

The incidence of femoral fractures in revision hip arthroplasty are more than that in primary arthroplasty meanwhile it is more in cementless than cemented stem.There are many risk factors for femoral fractures about total-hip replacements including: Cortical defects, Revision arthroplasty, Mismatched components, Pericapsular pathology, Loose components, Osteolysis, Osteoporosis and Trauma.Regarding periprosthetic femoral fractures classification, Vancouver Classification (1995) is considered the standard system in periprosthetic femoral fractures. It is based on fracture configuration, the quality of fixation of the stem as well as the quality of the bone and the site of fracture either trochanteric, about stem tip or below stem tip.Regarding the diagnosis either intra operative or postoperative which can be either by clinical examination of the patient or by radiological examination either for diagnosis of fracture (by X-ray) or diagnosis of its predisposing factors (MRI and bone scan).Periprosthetic fractures of the femur are difficult treatment problems requiring careful preoperative planning and availability of specialized implants as special plates and wires, cables and allografts or revision implants with long stem either cemented or cementless.