Surgical treatment of periprosthetic femoral fractures: a retrospective study with functional and radiological outcomes from 2010 to 2016

  • Gaetano CarusoEmail author
  • Lorenzo Milani
  • Tedi Marko
  • Vincenzo Lorusso
  • Mattia Andreotti
  • Leo Massari
Original Article • HIP - ARTHROPLASTY



The treatment of periprosthetic femoral fractures is a great challenge for the orthopedic surgeon and requires a knowledge of bone fracture fixation as well as skills and experience in revision surgery. The aim of this retrospective study was to evaluate the functional and radiological outcomes of periprosthetic femoral fractures surgically treated in our department from 2010 to 2016.

Materials and methods

This study involved 73 patients with a periprosthetic femoral fracture after total hip arthroplasty or hemiarthroplasty. Periprosthetic femoral fractures were classified using the Vancouver system. Functional outcomes were assessed using Harris hip score, Palmer Parker score, SF-36 score and ambulatory status. Radiological findings were classified using Beals and Tower’s criteria.


The mean age of patients was 79.6 years old. Local risks factors were identified in 67% of the patients, principally osteoporosis (63.0%), followed by osteolysis (26.0%) and loosening of the stem (8.2%). According to the Vancouver classification, there were 10 type A, 49 type B and 14 type C fractures. Of the type B fractures, 26 were B1, 17 were B2 and 6 were B3. Applying Beals and Tower’s criteria, radiological results were excellent in 24 patients (32.9%), good in 35 (47.9%) and poor in 14 (19.2%). The mean Harris hip score post-operatively was 72.5.


These kinds of fractures should be assessed individually and the optimal treatment plan should be made in accordance with the bone stock quality, stem stability, location of the fracture and patient expectations.


Periprosthetic femoral fractures Outcome Harris hip score Surgical treatment 


Compliance with ethical standards

Ethical approval

The study was approved by the local University Hospital Human Subject Research Ethics Committee, and data collection and analysis were performed in compliance with the Declaration of Helsinki.

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Biomedical and Specialty Surgical SciencesAzienda Ospedaliero-Universitaria di Ferrara – Arcispedale Sant’Anna, University of FerraraFerraraItaly

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