Journal
BONE & JOINT JOURNAL
Volume 105B, Issue 6, Pages 593-601Publisher
BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/0301-620X.105B6
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Periprosthetic femoral fractures, which are similar to pathological fractures, are increasing in frail elderly patients. The aim of treatment is to achieve immediate, unrestricted weightbearing with low complication rates and without stress risers that may lead to further fractures. The surgical approach, soft-tissue handling, and fracture exposure are crucial in minimizing complications.
Periprosthetic femoral fractures are increasing in incidence, and typically occur in frail elderly patients. They are similar to pathological fractures in many ways. The aims of treatment are the same, including 'getting it right first time' with a single operation, which allows immediate unrestricted weightbearing, with a low risk of complications, and one that avoids the creation of stress risers locally that may predispose to further peri-implant fracture. The surgical approach to these fractures, the associated soft-tissue handling, and exposure of the fracture are key elements in minimizing the high rate of complications. This annotation describes the approaches to the femur that can be used to facilitate the surgical management of peri- and interprosthetic fractures of the femur at all levels using either modern methods of fixation or revision arthroplasty.
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