State of the ArtPeriprosthetic Femur FracturesRicci, William M. MDAuthor Information Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO. Reprints: William M. Ricci, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 S Euclid Avenue, St Louis, MO 63110 (e-mail: [email protected]). W. M. Ricci is a consultant for Smith & Nephew, Stryker, and Biomet; receives institutional support from AONA, COTA, Smith & Nephew; receives royalties from Smith & Nephew, MicroPort (Wright Medical), Biomet (expected), Stryker (expected), and LWW (expected). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal's Web site (www.jorthotrauma.com). Accepted December 10, 2014 Journal of Orthopaedic Trauma: March 2015 - Volume 29 - Issue 3 - p 130-137 doi: 10.1097/BOT.0000000000000282 Buy SDC Metrics Abstract Summary: Successful treatment of periprosthetic femur fractures, like all fractures, requires careful attention to understand the fracture pattern nuances, identifying and executing a rational treatment approach, and providing an appropriate postoperative recovery protocol. Unlike most other fractures, modification of standard techniques is often required to obtain a stable fixation construct, and there is a greater role for revision arthroplasty in the treatment of periprosthetic fractures. Optimal indications for surgical repair versus revision arthroplasty and optimal postoperative weight-bearing protocols remain uncertain. Reported outcomes for patients with periprosthetic femoral shaft fractures are generally good and are relatively consistent. Results for periprosthetic distal femur fractures, however, are less good and more inconsistent. Both periprosthetic femoral shaft and distal femur fractures are associated with relatively high mortality rates, approaching that of patients with hip fractures. This review should provide insight into the current solutions and challenges for the treatment of patients with periprosthetic femur fractures. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.