To show the results of treatment of ipsilateral unstable femoral fracture during postoperative period of total hip arthroplasty.

We analyzed eight cases of ipsilateral unstable femoral fractures during the postoperative period of total hip arthroplasty, which were treated operatively from November 1992 to November 1995. The follow-up period ranged from 2 years to 3 years and 8 months (average, 2 years 8 months). There were seven cases of type B2 fractures and one case of type B3 fracture according to the Duncan's8) classification. All showed femoral stem loosening. One case was treated with revision of new femoral stem and internal fixation using wire. Six cases were treated with revision of long femoral stem and internal fixation using wire or Parham band. One case was treated with revision of long femoral stem and internal fixation using plate and wire. All cases had bone graft performed at the fracture site of femur.

The results of treatment of periprosthetic fractures showed that seven cases were satisfactory and one case was unsatisfactory. The complications were as follows: nonunion in one, heterotopic ossification in two, and one case of limb shortening.

The treatment of ipsilateral femoral fractures during postoperative period of total hip arthroplasty can be complex and difficult but revision arthroplasty with a new femoral stem prosthesis, combined with internal fixation and bone graft, may be satisfactory, if the femoral stem is displaced or loosened.