Periprosthetic fractures of the femur in total hip arthroplasty: Functional and radiological comparison of plate osteosynthesis and proximal femoral replacement.

Aim: Clinical and radiological examinations were performed to compare plate osteosynthesis (group 1) with replacement of the proximal femur by tumor prosthesis (group 2) in patients with ipsilateral femoral fractures around a hip prosthesis. Method Of 24 consecutive patients with 25 fractures, nine had died and one could be contacted by telephone leaving 14 hips (in one case only recent X-rays were available) for final review (nine patients from group 1; five from group 2). Results: At the time of examination four patients of group 1 were using one cane or were walking without any support, all patients of group 2 needed one or two crutches. In 5 of 9 patients in group 1 and in 4 of 5 in group 2 a firm fit of the prosthesis was observed. Conclusion: Group 1 achieved better clinical results in postoperative mobility, whereas femoral replacement showed better radiological results. Survival of patients with tumor prostheses was considerably superior to that of patients with plate osteosynthesis.