Management of Vancouver Type-B2 and B3 Periprosthetic Femoral Fractures: Restoring Femoral Length via Preoperative Planning and Surgical Execution Using a Cementless, Tapered, Fluted Stem.

Introduction: Periprosthetic femoral fractures, which are likely to increase as the population ages and total hip arthroplasty becomes more prevalent, can be effectively managed by restoring femoral length via preoperative planning and surgical execution using a cementless, tapered, fluted stem.

Step 1 Preoperative Plan: Template the contralateral, uninjured side.

Step 2 Template The Fractured Side: Identify the ideal COR on the injured side and template the femoral stem.

Step 3 Establish Depth Of Reaming: Use stem templates to establish a reference point on the reamer for use intraoperatively, and identify the distance from that point to an identifiable distal landmark.

Results: We report on 14 (12 Vancouver type-B2 and 2 Vancouver type-B3) periprosthetic femoral fractures treated with the described method.