Management of periprosthetic femur fractures treated with distal fixation using a modular femoral stem using an anterolateral approach.

The authors retrospectively analyzed 27 hips with periprosthetic femoral fractures (types B2 and B3) treated with distal fixation using a modular, fluted, femoral stem. The average follow-up was 4.8 years. Most fractures (25 hips) were united (92.6%), and mean Harris Hip Score at follow-up was 84.7. Subsidence was noted in 2 patients within 6 months postoperatively, but despite the subsidence, one achieved union. One patient developed peroneal nerve palsy. Two hips were defined as failure: one nonunion associated with infection, and the other one had 10 mm more subsidence. No dislocation occurred in any of the patients. This technique has proven to be reliable in the treatment of difficult fractures in the acute stage, although concerns regarding the subsidence remain when using this femoral stem.