Early Postoperative Femur Fracture After Uncemented Collarless Primary Total Hip Arthroplasty: Characterization and Results of Treatment

Thirty Vancouver type B periprosthetic fractures occurred within 90 days of total hip arthroplasty were identified using two institutional databases. Twenty-eight of these fractures were of a stereotyped fracture pattern consisting of a displaced fracture of the femoral neck including the lesser trochanter and a variable amount of the proximal medial femoral cortex creating a roughly triangular fragment. Time from operation until fracture was 2–88 days (mean 28). Mechanism of injury was fall from standing height in 12, no defined trauma in 11, stumble without fall in 5, and twisting motion in 2. Fracture treatment consisted of femoral revision in 24, fracture fixation in two, and nonoperative in four. Of the 24 treated with revision, 21 had healed fractures and stable revision stems.