Periprosthetic fractures of the femur after total hip arthroplasty are challenging to the orthopaedic surgeon. Location of the fracture and stability of the implant are the keys to their treatment. Fractures proximal to the tip of the stem, around a loose component, should be treated with a long stem revision. Fractions distal to a well-fixed component should be treated with extramedullary plate fixation using screws and cerclage wires.