title: Outcomes following surgical treatment of periprosthetic femur fractures: a single centre series.
abstract: BACKGROUND
  Periprosthetic femoral fracture after total hip arthroplasty (THA) is an increasing clinical problem and a challenging complication to treat surgically. The aim of this retrospective study was to review the treatment of periprosthetic fractures and the complication rate associated with treatment at our institution.
  
  
  METHODS
  We reviewed the cases of patients with periprosthetic femoral fractures treated between January 2004 and June 2009. We used the Vancouver classification to assess fracture types, and we identified the surgical interventions used for these fracture types and the associated complications.
  
  
  RESULTS
  We treated 45 patients with periprosthetic femoral fractures during the study period (15 men, 30 women, mean age 78 yr). Based on Vancouver classification, 2 patients had AL fractures, 9 had AG, 15 had B1, 24 had B2, 2 had B3 and 4 had C fractures. Overall, 82% of fractures united with a mean time to union of 15 (range 2-64) months. Fourteen patients (31%) had complications; 11 of them had a reoperation: 6 to treat an infection, 6 for nonunion and 2 for aseptic femoral component loosening.
  
  
  CONCLUSIONS
  Periprosthetic fractures are difficult to manage. Careful preoperative planning and appropriate intraoperative management in the hands of experienced surgeons may increase the chances of successful treatment. However, patients should be counselled on the high risk of complications when presenting with this problem.
authors.affiliation: From the University of Ottawa, Division of Orthopaedics, Ottawa, Ont.
authors.forename: Natasha
authors.initials: N
authors.lastname: Holder
authors.affiliation: From the University of Ottawa, Division of Orthopaedics, Ottawa, Ont.
authors.forename: Steve
authors.initials: S
authors.lastname: Papp
authors.affiliation: From the University of Ottawa, Division of Orthopaedics, Ottawa, Ont.
authors.forename: Wade
authors.initials: W
authors.lastname: Gofton
authors.affiliation: From the University of Ottawa, Division of Orthopaedics, Ottawa, Ont.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Beaulé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome