Conservative treatment after failure of internal fixation for periprosthetic femoral fractures: a report of two cases

Osteosynthesis using compression or locking plate following indirect fracture reduction and using a minimally invasive technique has been recommended for the surgical treatment of Vancouver B1 and C periprosthetic femoral fractures. Recent advancements in fracture healing emphasize the significance of the type of mechanical stability depending on fracture patterns and the importance of the preservation of the blood supply around the fracture sites. We report two cases of mechanical failure after internal fixation of periprosthetic femoral fractures despite adherence to the principles of fracture care. Both patients were treated conservatively with a thigh cuff cast due to other concurrent issues. Bone healing was successfully achieved in both cases as a result of the preservation of the tissues and the biology around the fractures during the initial operations. We present our experiences of conservative management together with the preservation of the biology around the fracture site, as viable alternative options for difficult and traumatic revision surgery in cases of failed periprosthetic fracture fixation procedures.