Dr. N. Prudhvi Raj
Abstract: Introduction: Fractures of the femur after hip arthroplasty are an increasingly common and a technically challenging problem. The results of nonsurgical treatment are poor. When the general condition of the patient allows, these injuries should be treated surgically. Cable-plate system can be used to provide easy anatomical reduction and a more stable fixation. Case report: A 61y old male patient with history of hypertension for 3 years presented with complaints of left hip and thigh pain since two days due to fall from height and with Patient had a history of bipolar hemiarthroplasty 7 years back over the left hip. On inspection, swelling and obvious bony deformity noted over left thigh. On palpation there was tenderness, crepitus and abnormal bony movements over the left thigh. X-ray findings showed a periprosthetic left femur fracture. This patient was surgically managed with locking compression plate with proximal cable fixation. Post-operative period was uneventful. The follow-up showed total weight bearing clinically and callus formation radiographically. A) Pre operative radiograph of left femur peri prosthetic fracture (Vancouver B1 fractures) B) Post operative radiograph of left femur peri prosthetic fracture showing locking compression plate with cerclage wire fixation C) 6 months Post operative radiograph of left femur peri prosthetic fracture Discussion: Now a days Incidence of periprosthetic femoral fracture are increasing  Femoral fractures at the tip of a total hip arthroplasty stem have been classified as Vancouver B1 fractures. Several factors likely predispose patients to periprosthetic femur fracture which include cracks or defects generated intra-operatively, regions in the bone that are not bypassed with a sufficiently long stem, previous hip surgery, and cortical thinning caused by a loose femoral component.
Keywords: Periprosthetic femoral fracture, hemi arthroplasty, Fixation