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Hybrid Fixation Utilizing a Custom Stem Extension for the Treatment of Periprosthetic Femoral Nonunions Around Well-Fixed Cylindrical Femoral StemsA Report of Two Cases
Abdulrahman D. Algarni, MD, SSC(Ortho), ABOS1; John Antoniou, MD, PhD, FRCSC2
1 Department of Orthopedic Surgery, King Saud University, P.O. Box 226638, Riyadh, 11324, Saudi Arabia. E-mail address: abdulrahmanga@gmail.com
2 Department of Orthopedic Surgery, McGill University, 3755 Cote-St. Catherine Road, Montreal, Quebec, Canada, H3T 1E2. E-mail address: janton@orl.mcgill.ca
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Investigation performed at McGill University, Montreal, Quebec, Canada

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Oct 23;3(4):e105 1-6. doi: 10.2106/JBJS.CC.L.00305
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Periprosthetic femoral nonunion associated with total hip arthroplasty is an infrequent complication1. However, the increasing worldwide incidence of periprosthetic fractures2 is expected to result in a higher number of complications, including fracture nonunion. A periprosthetic fracture around a well-fixed stem (e.g., Vancouver type B1)3 is a difficult complication to manage4, and it often requires both an arthroplasty and the skills of a trauma surgeon5. Nonunited fractures are even more challenging; they have a high rate of complications and relatively poor functional outcomes1.
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