The shattered femur: radical solution options.

The field of total joint arthroplasty has undergone a tremendous evolution over the past 5 decades. With increased arthroplasty use, indications expanding to younger patients, and increased life span, coupled with the limited longevity demonstrated by all arthroplasty devices to date, many patients have undergone at least one revision procedure. Therefore, reconstructive orthopedic surgeons may sometimes face the so-called shattered femur, defined as a femur that is not reconstructible with conventional methods. The clinical scenarios for which total femoral arthroplasty is indicated and a recommended surgical technique are reviewed.