Femoral shaft fracture after hip arthroplasty.

Femoral shaft fractures after hip arthroplasties were treated in 74 noncemented hemiarthroplasties and 65 cemented arthroplasties. In loose prostheses the best clinical results and the least number of operations were achieved with revision arthroplasty with a long-stem prosthesis, combined with simple internal fixation methods when applicable. In firmly fixed prostheses the results of revision arthroplasty and traction treatment were similar. Cemented revision arthroplasty did not interfere with fracture union. Internal fixation with the prosthesis in situ cannot be recommended because of a large number of secondary revision arthroplasties and nonunions. Removal of the femoral stem prosthesis and internal fixation nearly always require a secondary revision and cannot be recommended.