Management of periprosthetic fractures: the hip

Treatment of periprosthetic fractures around a total hip arthroplasty is based on fracture timing (intraoperative or postoperative) and fracture location (acetabulum or femur). Most intraoperative fractures are treated by ensuring that the implant and fracture are stable and employing minor technique modifications to ensure that the fracture remains stable postoperatively. Major intraoperative fractures require more complex reconstruction. Postoperative fractures associated with well-fixed implants typically are treated with open reduction and internal fixation. Postoperative fractures associated with loose implants are treated with revision and fracture stabilization, usually with specialized revision implants.