Proximal femoral fractures following total hip arthroplasty

Clin Orthop Relat Res. 1982 Oct:(170):95-106.


Thirty-one postoperative fractures around the femoral component of previous total hip arthroplasties were reviewed retrospectively until healing occurred. This type of injury seemed to be associated with either high-velocity trauma or weakening of bony stock secondary to stress risers from prior surgery or loosening. These fractures were classified as Type A at the stem tip, Type B spiralling around the stem, and Type C comminuted around the stem. Type A fractures have a significant incidence of nonunion in the face of multiple previous proximal femoral surgeries, but, after healing, usually show no loosening. Type B fractures usually will heal without operative intervention but have a high incidence of associated eventual component loosening. Type C fractures need immediate surgery to allow mobilization of the elderly patient. When postfracture revision surgery with long-stem component or plating is required, the technical order of priority should be adequate bony apposition of fracture fragments, good cement technique at the proximal femur, bone grafting.

MeSH terms

  • Adult
  • Aged
  • Female
  • Femoral Fractures / etiology
  • Femoral Fractures / surgery
  • Femoral Fractures / therapy*
  • Fractures, Spontaneous / etiology
  • Hip Joint / surgery*
  • Hip Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Wound Healing