Periprosthetic fractures of the proximal femur: beyond the Vancouver classification

Karl Stoffel; Tamara Horn; Luigi Zagra; Michael Mueller; Carsten Perka; Henrik Eckardt

doi:10.1302/2058-5241.5.190086

Periprosthetic fractures of the proximal femur: beyond the Vancouver classification

EFORT Open Rev. 2020 Aug 1;5(7):449-456. doi: 10.1302/2058-5241.5.190086. eCollection 2020 Jul.

Authors

Karl Stoffel¹, Tamara Horn², Luigi Zagra³, Michael Mueller⁴, Carsten Perka⁴, Henrik Eckardt¹

Affiliations

¹ Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.
² Clinic of Orthopaedic Surgery, Kantonsspital Baselland, Liestal, Switzerland.
³ Hip Department, IRCCS Galeazzi Orthopaedic Institute, Milano, Italy.
⁴ Orthopaedic Department, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Abstract

The majority of periprosthetic femoral fractures are treated surgically.Surgical treatment may be revision only, revision in combination with open reduction and internal fixation (ORIF), or ORIF only.The treatment decision is dependent on whether the stem is loose or not, but loose stems are not always identified, resulting in unsatisfactory treatments.This article presents an algorithmic approach to identifying loose stems around proximal femoral periprosthetic fractures, taking patient history, stem design, and plain radiographs into consideration. This approach may help identifying loose stems and increase the probability of effective treatments. Cite this article: EFORT Open Rev 2020;5:449-456. DOI: 10.1302/2058-5241.5.190086.

Keywords: algorithm; loose stem; periprosthetic femoral fracture; revision total hip arthroplasty.

Publication types

Review