Surgical Management of Repeated Low-Energy Periprosthetic Femur Fractures - A Case Report -

Periprosthetic fracture of the femur is an uncommon complication after total hip arthroplasty (THA), but it appears to be increasing in incidence as a result of the aging population demographics and the increased number of THAs that are being performed. Much interest has been generated regarding low energy fractures in the elderly, but repeated periprosthetic fractures in the same femur are uncommon. The authors present here the case of a 71 year old patient who sustained repeated low energy ipsilateral periprosthetic femur fractures. The initial injury was caused by a road traffic accident, but the subsequent fractures were all caused by low energy falls. The patient sustained proximal and distal femur fractures with implants in situ. The probable causes of such fractures was a combination of systemic and local host factors, such as osteoporosis, cortical stress risers, local osteopenia secondary to bed rest, quiescent infection and altered fracture site vascularity due to the internal fixation devices and multiple re-operations.