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Updated: May 6, 2026

Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
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Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research

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Conclusions.

E Gagneux1, L Jeunet, P Vichard

  • 1Service de Chirurgie Orthopédique Traumatologique et Plastique, C.H.U. J. Minjoz, Boulevard Fleming, F-25000, Besançon, France.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|November 7, 2013
PubMed
Summary
This summary is machine-generated.

This study identifies femoral fragilization and iatrogenic factors as key causes of periprosthetic fractures. Treatment strategies vary based on fracture type and prosthesis stability, with a proposed modification to the Johansson classification.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Traumatology

Background:

  • Periprosthetic fractures, particularly around femoral implants, pose significant challenges in orthopedic practice.
  • Femoral fragilization, stemming from bone stock loss (osteopathies, tumors, prosthetic loosening) or iatrogenic causes, is a primary predisposing factor.

Purpose of the Study:

  • To define predisposing factors for periprosthetic femoral fractures.
  • To outline treatment methods based on fracture characteristics and prosthesis stability.
  • To propose a modification of the existing Johansson classification system.

Main Methods:

  • Retrospective multicentric study analyzing patient data and fracture patterns.
  • Classification of fractures according to the Johansson system.
  • Evaluation of treatment outcomes for different fracture types and stability conditions.

Main Results:

  • Common predisposing factors include femoral fragilization and iatrogenic causes like excessive femoral manipulation or improper implant placement.
  • Treatment for Type I fractures ranges from functional management to internal fixation or revision arthroplasty, depending on prosthesis stability.
  • Type II and III fractures often necessitate internal fixation or revision arthroplasty, with specific considerations for elderly or compromised patients.

Conclusions:

  • A modified Johansson classification is proposed to better guide treatment decisions for periprosthetic femoral fractures.
  • Tailored treatment strategies, considering fracture type, stability, and patient condition, are crucial for optimal outcomes.
  • Understanding predisposing factors aids in fracture prevention and management.