Interprosthetic femoral fractures-A challenge of treatment. A systematic review of the literature

The success of prosthetic surgery has led to an increase in the percentage of the population having more than one prosthetic implant. This, combined with an increase in the average life expectancy and functional requirements for the elderly, has led to a higher incidence of periprosthetic and interprosthetic fractures. More precisely, the femoral shaft is compressed between two ipsilateral implants with most of these fractures being located on the supracondylar femoral shaft. Their treatment is not only technically demanding and challenging, but can also be associated with serious complications. Treatment must be determined and assessed according to the type of fracture, the stability of the prosthesis, the bone quality and the general condition of the patient. There is little information in the literature about this type of injury: there are several published case reports detailing unconventional solutions and the case studies presented are limited and not significant. This review aims to provide an updated and comprehensive list of diagnostic and therapeutic protocols accepted today, while recognising that these protocols are being continuously updated according to experience gained. (C) 2013 Elsevier Ltd. All rights reserved.