[Periprosthetic Femoral Fractures: Classification and Therapy]

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Periprosthetic femoral fractures are increasing due to more primary arthroplasties and an aging population.
• These fractures occur proximally around hip stems or distally around knee arthroplasties.
• This paper specifically addresses proximal periprosthetic femoral fractures.

Purpose of the Study:

• To emphasize the importance of accurate fracture classification and surgical planning for proximal periprosthetic femoral fractures.
• To outline the decision-making process for surgical intervention based on implant fixation status.
• To highlight the challenges and necessary competencies for managing these complex fractures.

Main Methods:

• Fracture classification at diagnosis.
• Surgical planning based on implant fixation (loose vs. fixed).
• Decision for revision surgery or open reduction and internal fixation.

Main Results:

• Distinguishing between loose and fixed implants is crucial for treatment selection.
• Revision surgery is required for loose implants.
• Open reduction and internal fixation are options for fixed implants.
• Availability of all implant types is essential due to potential intraoperative plan changes.

Conclusions:

• Effective management of proximal periprosthetic femoral fractures demands precise classification and surgical planning.
• Treatment strategies must adapt to implant fixation status.
• Anticipated increases necessitate enhanced surgical expertise and interdisciplinary collaboration for these challenging cases.