Challenge of the Week / Hip / 11.15.19

Which of the following accurately describes the treatment of a periprosthetic femoral fracture distal to a well-fixed femoral implant (Vancouver type C)?
    • It is important to avoid a stress riser by overlapping the plate with the femoral stem
    • This is the best method to avoid a stress riser in this situation

 

  • A strut should be used even when the bone stock is adequate

Struts are only necessary for inadequate bone stock

 

 

  • Revising the femoral stem is necessary to achieve fixation in the distal bone fragment

Stem revision is not necessary as long as it is well-fixed

 

 

  • Use of a retrograde intramedullary nail eliminates concern for a stress riser

A retrograde nail would actually help create a stress riser between the tip of the nail and the distal end of the femoral stem

 

 

 

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