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Periprosthetic Femur Fracture T84.049A 996.44

ICD-9 Classification / Treatment
Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References


Periprosthetic Femur Fracture ICD-10


A- initial encounter

D- subsequent encounter

S- sequela

Periprosthetic Femur Fracture ICD-9

Periprosthetic Femur Fracture Etiology / Epidemiology / Natural History

  • 996.41 mechanical loosening of prosthetic joint
  • 996.44 peri-prosthetic fracture around prosthetic joint 
  • 996.45 periprosthetic osteolysis

Periprosthetic Femur Fracture Anatomy


Periprosthetic Femur Fracture Clinical Evaluation


Periprosthetic Femur Fracture Xray / Diagnositc Tests

  • Consider ESR and CRP.  11% of periprosthetic fractures have concomitant infection.  (Chevillotte CJ, Ali MH, Trousdale RT, Larson DR, Gullerud RE, Berry DJ. Inflammatory laboratory markers in periprosthetic hip fractures. J Arthroplasty. 2009 Aug;24(5):722-7)

Periprosthetic Femur Fracture Classification / Treatment

  •  Vancouver classification
  • Type A=proximal to prosthesis (trochanteric region_:
  • Type B1=fracture around the stem or at the tip of the stem with component solidly fixed.
    -Treatment=plating vs allograft strut
  • Type B2=femor fracture around or just distal to a loose stem with adequate proximal bone stock.
    -Treatment= revision with long porous-coated cylindrical stem.
  • Type B3=femor fracture around or just distal to a loose stem with poor proxmial bone
    -Treatment: revision to long stem prosthesis +/- bone grafting/strutt. Consider proximal femoral replacement for elderly inactive patients. (Klein GR, JBJS 2005;87Am:1777).
  • Type C=distal to prosthesis, treated independently
  • Lateral locked plating with indirect reduction (Ricci WM, JOT 2006;20:190).

Periprosthetic Femur Fracture Associated Injuries / Differential Diagnosis


Periprosthetic Femur Fracture Complications


Periprosthetic Femur Fracture Follow-up Care


Periprosthetic Femur Fracture Review References

  • Duncan CP, ICL 1995;44:293
  • Parvizi J, JBJS 2004;86A:8
  • Younger AS, ICL 1998;74:251
  • Lee SR, ICL 2004;53:111





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