Treatment of periprosthetic fractures in total hip endoprosthetics: a modern review of surgical opportunities

Periprosthetic fractures are a challenge for the surgeon and medical team. Surgical treatment can be technically challenging. Historically, non-surgical treatment of injuries, such as a cast or leg traction, has shown unacceptably high rates of morbidity and mortality. Several techniques have been described for the treatment of these complex lesions, which may include internal fixation or in-situ revision of the prosthesis. While internal fixation may include a locking plate, cable plate, orthogonal plate, and the use of an allograft or autograft, there is no consensus on the ideal approach. In addition, there is controversy regarding the type of plate, length and distance between the prosthesis and the bone. Potential complications after surgery include blood loss, loosening, breaking or fusion of bones, further fractures, and infections.