Internal fixation of a traumatic fracture around a hip resurfacing arthroplasty using the proximal femoral locking compression plate

We report on a 40-year-old man who sustained a traumatic extracapsular fracture of the proximal femur with a Birmingham Hip Resurfacing in situ. It was decided to retain the resurfacing implant and a proximal femoral periarticular locking compression plate (Synthes) was used to stabilise the fracture. The patient regained full range of pain-free movement, and was bearing his full weight on the operated leg by 18 weeks. He had a Harris Hip score of 90. Fractures around hip resurfacing arthroplasties are an emerging problem, and a literature review reveals two distinct modes of presentation i.e. 'atraumatic' and 'traumatic' fractures. We elaborate on these two different fracture patterns, with emphasis on the epidemiology, biomechanical considerations, and management strategies for the 'traumatic' type of periprosthetic fracture.