Open reduction and internal fixation with cables for the variant A GT Periprosthetic fracture: a case report and literature review

Periprosthetic femoral fracture is identified as the third most frequent reason for revision total hip arthroplasty (THA). Treatment of periprosthetic fractures of the femur after THA remains a surgical challenge. In this report, we presented 2 patients with periprosthetic proximal femur fracture variant (a fracture of the greater trochanter with lateral cortical extension) and femoral stem destabilization. Two patients presented with chief complaints of pain in hip, restricted hip movements and gait changes. On the basis of clinicoradiological findings, the patients were diagnosed as pseudo AGT periprosthetic fracture, since the stem was loosened. They underwent open reduction and internal fixation (ORIF) with cables. After 2 years of follow-up, the 2 patients had favorable clinical outcomes after operation. Both lower limbs of the 2 patients were of equal length. The Harris score of the two hips was 96 and 94, respectively. CT scan worked better than X-ray examination in the diagnosis of prosthetic looseness with this type of fracture. Compared to longer-stem revision, ORIF with cables could also achieve good result with these fractures.