Periprosthetic Fractures Around Total Hip Arthroplasty with a Stable Component

  • Peter J. Shekailo
  • Erik N. Kubiak
  • Richard S. Yoon
  • Frank A. Liporace


Periprosthetic femur fractures about a total hip arthroplasty (THA) are increasing. A subset of these fractures involve fractures of the femur around a stable femoral prosthesis. These fractures include fractures of the greater trochanter (Vancouver AG), fractures at the level of the stem with a stable femoral prosthesis (Vancouver B1), and fractures below the level of the femoral stem (Vancouver C). Most Vancouver Ag fractures can be treated nonoperatively unless the displaced fracture is greater than 2.5 cm or patient has painful nonunion or limp. Vancouver B1 and Vancouver C fractures are treated with open reduction internal fixation techniques. With these fractures, accurate assessment of radiographs must be performed preoperatively to assess for stem stability. Revision implants should be available if component loosening or failure is observed intraoperatively. This chapter summarizes different surgical techniques and tips for management of these fractures.


Stable femoral component Vancouver A Vancouver B1 Vancouver C Trochanteric claw Osteolysis Minimally invasive plate osteosynthesis (MIPO) Lateral locked plating Allograft strut Hybrid plating 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Peter J. Shekailo
    • 1
  • Erik N. Kubiak
    • 2
  • Richard S. Yoon
    • 3
  • Frank A. Liporace
    • 3
  1. 1.Division of Orthopedic Trauma and Adult Reconstruction, Department of Orthopedic SurgeryOrlando Regional Medical CenterOrlandoUSA
  2. 2.Division of Orthopedic Trauma and Adult Reconstruction, Department of Orthopedic SurgeryUniversity of Nevada – Las VegasLas VegasUSA
  3. 3.Division of Orthopedic Trauma and Adult ReconstructionJersey City Medical Center – RWJBarnabas HealthJersey CityUSA

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