Treatment of periprosthetic femoral fractures with the Bicontact revision stem.

Purpose: Periprosthetic fractures in cases without prior loosening of the stem can be treated with open reduction and internal fixation, but cases with preexisting loosening and/or bone defects present specific challenges to the surgeon. The keys to the success of intramedullary stabilization of femoral fractures--reconstruction of length, axis and rotation rather than meticulous reduction of the fragments and minimal impact on fragment vascularization by the surgical approach--can be transferred to the treatment of periprosthetic fractures.

Method: The Bicontact revision stem can be regarded as a combination of an interlocking nail in its distal part and a proximally coated femoral stem in its proximal part.