Management and outcome of interprosthetic femoral fractures

Periprosthetic fractures: epidemiology and current treatment

“…Treatment is extremely variable (conservative, ORIF, revision surgery of one or both joints involved) and depends on stability of the implants. (44). Type E is a fracture of each of two bones supporting one arthroplasty or polyperiprosthetic; the "block out analysis" concept is the same required to be used in D fractures.…”

Interprosthetic femoral fractures treated with locking plate

“…Soenen et al reported one of 14 patients dying within six months of the fracture event [12]. Platzer et al reported one of 23 patients dying from cardiac arrest 15 days postoperatively [13], and Ehlinger et al reported one death out of eight patients four months after operation [19]. This study reports three of 15 patients dying within six months postoperatively, including one patient already full weight bearing.…”

“…Platzer et al proposed a modified Vancouver Classification, which assessed fracture proximity to the prosthesis and prosthesis stability [13]. For fracture location classification, type I is no adjacency, type II is adjacency to one prosthesis and type III is adjacency to both prostheses.…”

“…Seven patients had satisfactory clinical and radiological results. Platzer et al studied 23 patients [13]: 19 had stable fractures and were treated with lateral plate fixation, with five requiring cerclage, two using angular stable plate fixation with cerclage and hip-shaft replacement and two undergoing revision THA. Fracture healing within six months occurred for 86 % of their patients.…”

“…Treating interprosthetic fractures is challenging because there is limited bone stock, frequently poor bone quality and limited blood supply. Several authors have reported on this challenging situation [10][11][12][13][14][15][16][17]. A recent review by Solarino et al showed there were 127 cases of interprosthetic femoral fractures in the literature [18].…”