Table 2. Comparison of treatment options in periprosthetic femoral fractures.

	Angle-stable plate osteosynthesis	Nail osteosynthesis	Revision arthroplasty
Indications	Lewis-Rorabeck type I + II Vancouver type B1 + C	Lewis-Rorabeck type I + II	Lewis-Rorabeck type III Vancouver type B2 + B3
Complications
Infections	5.3–14.3%	0–2.9%	3%
Non-unions	5.3–7%	3.3–29%	3%
Revision required	8.8–14.3%	4.6–40%	5%
Mortality	4.54–13.4%	0–22%	14.5%
Advantage	Primary and rotation stability Usable with osteoporosis As anatomically preformed plates Soft tissue sparing approach possible In addition polyaxial angle-stable Intraoperative flouroscopy time Early functional follow-up treatment	Primary and rotational stability Central force flow (intramedullary) Soft tissue sparing approach Early functional follow-up treatment	Primary stability Central force flow Early functional follow-up treatment
Disadvantage	Complication rates Implant bed discrimination Correction loss with comminuted fracture Off-center force flow	Reposition difficult Loss of stability with: wide medullary space spiral fractures osteoporosis Intercondylar distance limited Intraoperative flouroscopy time Fracture-implant distance postoperative leg length differences Postoperative mechanical axis deviations	soft tissue trauma bone loss postoperative THA dislocation postoperative leg lenghth difference

THA, Total hip arthroplasty; TKA, total knee arthroplasty