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Published on: June 6, 2025
Interprosthetic femoral fractures
Christiaan N Mamczak1, Michael J Gardner, Brett Bolhofner
1Washington University Orthopaedics, St. Louis, MO, USA.
Journal of Orthopaedic Trauma
|November 11, 2010
Summary
Interprosthetic femoral fractures, occurring between hip and knee implants, are often supracondylar. Biologic plating techniques spanning the fracture zone achieve reliable healing without bone grafts.
Area of Science:
- Orthopaedic surgery
- Trauma surgery
- Biomechanical engineering
Background:
- Interprosthetic femoral fractures are complex injuries occurring between ipsilateral hip and knee arthroplasties.
- These fractures present a significant challenge due to the compromised bone stock and proximity of implants.
Purpose of the Study:
- To evaluate fracture locations and treatment outcomes for interprosthetic femoral fractures.
- To assess the efficacy of femoral plate fixation spanning the interprosthetic zone using biologic, tissue-preserving techniques without bone grafts.
Main Methods:
- Retrospective cohort study at two trauma centers.
- Reviewed 20 interprosthetic femur fractures in elderly patients (average age 80) treated with plate fixation.
- Fracture patterns (femoral shaft vs. supracondylar) and outcomes were analyzed.
Main Results:
- Supracondylar fractures (OTA 33) were more common (65%) than diaphyseal fractures (OTA 32) (35%).
- All 20 fractures achieved union with an average time to weightbearing of 13 weeks.
- Complications included three malunions and two cases of painful implants, all in supracondylar fractures.
Conclusions:
- Interprosthetic femoral fractures predominantly occur in the supracondylar region near knee arthroplasty components.
- Biologic plating techniques spanning the interprosthetic zone provide reliable fracture healing and implant survivorship without bone grafting.
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