Authors of section

Executive editor

Michael Baumgaertner

Authors

Michael Huo, Michael Leslie, Iain McFadyen

Open all credits

Fracture proximal to the femoral component

General considerations

These fractures occur proximal to the femoral component. It is important to evaluate prosthesis stability to determine if fixation is appropriate.

Intramedullary nailing is often desirable and so information about the presence of an open or closed box is needed.

These fractures are classified by UCPF as V.3-C.

definition

Etiology

Commonly these occur following a simple fall from standing height.

Occasionally, more active patients might sustain a high energy fracture.

Clinical signs

Similar to other femoral shaft or distal femur fractures.

Signs are:

  • Pain
  • Swelling
  • Deformity
  • Significant blood loss

Imaging

Plain X-rays remain the first line of investigation.

CT Scan is rarely helpful. It may be used to assess possible loosening at the implant interface or occult fracture extension.