Cases: Two patients with periprosthetic femur fracture proximal to a femoral osseointegration had surgical stabilization. These cases produced operative challenges because commonly used intraoperative traction methods cannot be used for patients with transfemoral osseointegration.
Conclusion: We describe a novel technique to apply traction and rotation to the osseointegrated extremity: using the implant's antirotation propeller handle. This allows for an otherwise familiar technique to be used for fracture fixation: open reduction with internal fixation using a proximal femur hook plate and eccentric peri-implant screws.
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