Fractures of the femoral shaft adjacent to long stem femoral components of total hip arthroplasty: report of seven cases.

Seven femoral shaft fractures adjacent to the distal aspect of long stem revision femoral components of total hip arthroplasty were evaluated at a mean of 6 years (range: 2 to 12) after fracture. Nonoperative treatment with a spica cast was used in four patients. Complications were delayed union in two patients and malunion in two. Operative treatment included revision and bone grafting in one patient and open reduction and internal fixation in two. Plate fracture and delayed union occurred in one patient. Operative treatment resulted in no malunions and earlier recovery of function than with nonoperative management. Femoral shaft fractures adjacent to long stem total hip arthroplasties are difficult to manage; the complication rate is 71%.