Introduction. The ever-expanding indications for total hip arthroplasty are leading to more implants being placed in younger as well as in older patients with high functional demand. Also, prolonged life expectancy is contributing to an overall increment of periprosthetic femoral fractures. The Vancouver classification has been the most used for guiding the surgeon choice since its proposal in 1995. Fractures occurring over a hip femoral implant can be divided into intra-operative and post-operative PFFs, and their treatment depends on factors that may severely affect the outcome: level of fracture, implant stability, quality of bone stock, patients’ functional demand, age and comorbidities, and surgeon expertise. There are many different treatment techniques available which include osteosynthesis and revision surgery or a combination of both. The goals of surgical treatment are patients’ early mobilization, restoration of anatomical alignment and length with a stable prosthesis and maintenance of bone stock. Significance. The aim of this review is to describe the state-of-the-art treatment and outcomes in the management of PFFs. We performed a systematic literature review of studies reporting on the management of PFFs around hip stems and inter-prosthetic fractures identifying 45 manuscripts eligible for the analysis. Conclusions. PFFs present peculiar characteristic that must be considered and special features that must be addressed. Their management is complex due to the extreme variability of stem designs, the possibility of having cemented or uncemented stems, the difficulty in identifying the “real” level of the fracture and the actual stability of the stem. As a result, the definition of a standardized treatment is unlikely, thereby high expertise is fundamental for the surgical management of PPFs, so this kind of fractures should be treated only in specialized centres with both high volume of revision joint arthroplasty and trauma surgery.

介绍。全髋关节置换术的适应症不断扩大，导致更多的植入物被植入到具有高功能需求的年轻和老年患者中。此外，预期寿命的延长导致假体周围股骨骨折的总体增加。自 1995 年提出以来，温哥华分类一直是最常用于指导外科医生选择的分类。发生在髋关节股骨植入物上的骨折可分为术中和术后 PFF，其治疗取决于可能严重影响股骨植入的因素。结果：骨折程度、种植体稳定性、骨量质量、患者的功能需求、年龄和合并症以及外科医生的专业知识。有许多不同的治疗技术可供选择，包括接骨术和翻修手术或两者的组合。手术治疗的目标是患者的早期活动、通过稳定的假体恢复解剖排列和长度以及维持骨量。意义。本次综述的目的是描述 PFF 管理中最先进的治疗方法和结果。我们对髋关节周围 PFF 和假体间骨折的治疗报告进行了系统的文献综述，确定了 45 份符合分析条件的手稿。结论。 PFF 具有必须考虑的独特特征和必须解决的特殊特征。由于柄设计的极端可变性、骨水泥柄或非骨水泥柄的可能性、识别骨折的“真实”水平和柄的实际稳定性的困难，它们的管理是复杂的。 因此，标准化治疗的定义不太可能，因此高专业知识对于 PPF 的手术治疗至关重要，因此这种骨折只能在具有大量翻修关节置换术和创伤手术的专业中心进行治疗。