PERIPROSTHETIC FRACTURES OF THE FEMUR - AN ANALYSIS OF 93 FRACTURES

A retrospective review of 93 periprosthetic fractures and 102 peripros thetic fracture treatments showed that the type of prosthesis (cemente d, ingrowth, Austin-Moore) and the presence of preexisting stress rise rs play a role in determining where the fractures occur, The site of f racture and the prefracture interface influence treatment of periprost hetic fractures, This study suggests that fractures associated with a loose interface, cemented or cementless, are best treated by removal o f the prosthesis, reduction of the fracture, and insertion of a long s temmed prosthesis with additional fixation as needed, Treatment of a p eriprosthetic fracture associated with a stable prosthesis depends on the site of fracture. Fractures proximal to the tip of a fixed prosthe sis usually call be treated nonoperatively or with limited internal fi xation, Fractures at the tip of the prosthesis mag be managed by revis ion or internal fixation, and fractures below the prosthesis carl be m anaged operatively or nonoperatively.