Avoiding a Proximal Femoral Replacement During the Management of a Critical‐Sized Subtrochanteric Bone Defect

Periprosthetic fractures are rare following a total hip arthroplasty (THA). They are often classified using the Vancouver system and are treated operatively with internal fixation or revision THA depending on the classification. Determining the appropriate classification for periprosthetic fractures can greatly influence the treatment a patient receives. With most cases occurring in emergent and urgent settings, management of periprosthetic fractures requires agreement between arthroplasty and trauma subspecialists on the classification and effective treatment strategies to help mitigate postoperative complications. We present a case where periosteal stripping from either trauma, approach, or the application of cerclage wires/cables created a critical‐sized bone defect in the subtrochanteric region of the femur after a Vancouver B2 periprosthetic proximal femoral fracture managed without the use of a proximal femoral replacement.