@article{ATM7850,
author = {Andrew Fleischman and Antonia F. Chen},
title = {Periprosthetic fractures around the femoral stem: overcoming challenges and avoiding pitfalls},
journal = {Annals of Translational Medicine},
volume = {3},
number = {16},
year = {2015},
keywords = {},
abstract = {Management of periprosthetic fractures around the femoral stem after total hip arthroplasty (THA) represents a significant challenge and optimal treatment remains controversial. The most common treatment paradigm involves treating fractures around a well-fixed stem with osteosynthesis, whereas fractures around a loose stem require revision arthroplasty and those with poor bone require augmentation with bone graft. Paradoxically, the literature reports a higher rate of failure for osteosynthesis around prostheses considered to be well-fixed. Such a high rate of poor outcomes may result not only from difficult fracture fixation and compromised biologic healing, but also from unrecognized peri-implant pathology. Therefore, proper preoperative and intraoperative evaluation is key, and a subset of patients may benefit from alternative management. We review the appropriate methods for evaluation and treatment of Vancouver type B fractures with particular emphasis on avoiding missteps that can lead to failure.},
issn = {2305-5847}, url = {https://atm.amegroups.org/article/view/7850}
}