Table 1.

Summary of management of periprosthetic fracture of the femur

Fracture type	Description of fracture	Treatment recommendation
I	Undisplaced fracture and well-fixed prostheses	Bracing, nonweightbearing
II	Displaced fracture and well-fixed prostheses
	A. Good-quality bone	Internal fixation using conventional plate, intramedullary nail or locking plate
	B. Poor-quality bone with osteopenia and comminution
	1. Decent-size distal fragment	Intramedullary nail or locking plate
	2. Extremely distal fracture	Locking plate or buttress plate with strut allograft
III	Displaced fracture, loose prostheses
	A. No metaphyseal bone loss	Revision knee arthroplasty using a long-stemmed femoral implant
	B. Metaphyseal bone loss or nonunion following previous surgery	Structural allograft–prostheses composite or distal femoral replacement prosthesis