Fracture of the femur distant to the implant
General considerations
Simple or comminuted fracture patterns distal to the stem are classified as type IV.3-C fractures by UCPF. These fractures are independent of the prosthesis.
Etiology
These can be low energy fragility fractures or high energy fractures associated with trauma. Pathologic fracture must always be considered.
Clinical signs
- Deformity of the lower limb
- Ecchymosis
- Pain
- Leg length discrepancy
Imaging
Full length AP and lateral radiographs of the femur usually reveal the complexity of the fracture. CT scan may be relevant if the fracture could be intraarticular at the knee.
Look for asymmetric liner wear and associated osteolysis.
