[Classification of femoral shaft fractures in hip arthroplasties]

Fractures of the femoral shaft around cemented hip prosthesis have become increasingly common and are difficult to manage. These fractures are often complex and may occur late after the insertion of a cemented prosthesis. They often occur in relation to cortical defects produced by cement and previous surgery. The main classifications already described can be divided into "anatomic" classifications (founded on the level of the fracture on the shaft: Parrish 1964, Ali Khan 1977, Van Elegem 1979) or into "prosthetic" classifications (founded on the level of the fracture with respect to the tip of the prosthesis: Johansson 1981, Bethea 1982, Cooke 1988). But these classifications give few guideliness to help the choice of the most appropriate form of treatment. The aim of treatment, which remains controversial, is to return to weight-bearing and mobility as promptly as possible so preventing the complications of immobilization which are frequent and serious in the often elderly population.