The management of periprosthetic fractures around the femoral stem.

©2004 British Editorial Society of Bone and Joint Surgery doi:10.1302/0301-620X.86B1.14864 $2.00 J Bone Joint Surg [Br] 2004;86-B:13-9. Total hip replacement is the second most common elective surgical procedure performed in the UK. It is estimated that by 2010 Europe will have more people over 60 years of age than under 20 years. The number of total hip replacements will therefore continue to rise in an ageing population, as will the frequency of occurrence of periprosthetic fractures. These injuries may occur during or after operation. The incidence of post-operative periprosthetic fractures has remained relatively constant, ranging from 0.6% after primary arthroplasty to 2.4% after revisions.1 This article deals only with post-operative fractures, and seeks to review the available surgical techniques and to develop a management algorithm.