Aim: We present our experience with 20 periprosthetic femoral fractures which were treated with a Biomet plate. Aim of the current study is to clarify the indications of the method and emphasize on the importance of fracture classification in the preoperative planning.

Material-methods: Retrospective study of 20 patients treated between 1999 and 2001. Ten of the patients sustained a periprosthetic fracture around a total hip replacement, 8 around a hemiarthroplasty and 2 around a revised total hip replacement.

Fractures were classified according to the Vancouver classification system. The mechanism of injury, the ambulatory status prior to the fracture and the loosening zones (according to Gruen) were studied.

Results: In 14 patients the results were satisfactory and in 3 poor. Three patients died during follow up. There were marked differences in the outcome depending on the fracture type. In B1 and C fractures the results were satisfactory. Patients with a B3 fracture had a worse outcome.

Patients with a periprosthetic fracture around a hemiarthroplasty had better results compared to those with a fracture around a total hip replacement. Poorer outcomes were noticed in patients with a periprosthetic fracture around a revised total hip replacement.

Conclusion: A careful patient selection is important for the success of the method. The accurate classification of the periprosthetic fractures helps in the preoperative planning.