The Vancouver Classification of Periprosthetic Fractures of the Hip: A Rational Approach to Treatment

Summary: The difficulty in treating a periprosthetic fracture following total hip arthroplasty is evidenced by the many modalities and techniques currently described in the orthopaedic literature. There is no ideal treatment that is appropriate for all fractures. A number of classification systems have previously been proposed; however, these mainly depend only on the site or pattern of the fracture. We propose a classification system that incorporates such factors as location of the fracture, status of stem fixation, and quality of bone stock. When these various factors are considered, they allow for a more rational approach to treatment.