title: Principles of internal fixation and selection of implants for periprosthetic femoral fractures.
abstract: Periprosthetic femoral fractures (PFF) are increasing as a result of changes in population demographics and the increase in the number of total hip replacements performed. The overall incidence has been reported to range from 0.1% to 6% of all total hip arthroplasties. Management of these fractures is often particularly demanding, complex and expensive. In many cases, the surgeon has to solve the simultaneous problems of implant loosening, bone loss and fracture. A thorough understanding of the unique characteristics of the different fracture types, the principles of PFF treatment and a familiarity with the various fixation devices, grafts and prosthetic implants are all of paramount importance. Internal fixation is used either alone or as an adjunct to stem revision. The stability of the original implant and the configuration of the fracture itself are the basic factors that influence the decision-making process. The current study reviews the existing literature on internal fixation of femoral periprosthetic fractures.
authors.affiliation: Department of Trauma & Orthopaedic Surgery, Academic Unit, School of Medicine, University of Leeds, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds, United Kingdom. pgiannoudi@aol.com
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: Nikolaos K
authors.initials: NK
authors.lastname: Kanakaris
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D001860:Bone Plates; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure