1. Hybrid Fixation Utilizing a Custom Stem Extension for the Treatment of Periprosthetic Femoral Nonunions Around Well-Fixed Cylindrical Femoral Stems by Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect Volume 3(4):e105 October 9, 2013 ©2013 by The Journal of Bone and Joint Surgery, Inc.

2. Anteroposterior radiograph of the left femur showing a hypertrophic nonunion with broken hardware (Case 1). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.

3. The existing femoral stem (A), the custom tapered adaptor sleeve (B), and the custom stem extension with the interlocking screw holes (C) are shown (Case 1). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.

4. Anteroposterior (Figs. 3-A and 3-B) and lateral (Figs. 3-C and 3-D) radiographs demonstrate the union with the custom implants in situ (Case 1). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.

5. Preoperative anteroposterior (Fig. 4-A) and lateral (Fig. 4-B) radiographs of the left femur (Case 2). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.

6. Figs. 5-A and 5-B Anteroposterior views of the existing femoral stem (green), the custom tapered adaptor sleeve (blue), and the custom stem extension with the interlocking screw holes (arrow) (Case 2). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.

7. Anteroposterior (Fig. 6-A) and lateral (Fig. 6-B) radiographs showing the healed nonunion with the custom implants in situ (Case 2). Abdulrahman D. Algarni, and John Antoniou JBJS Case Connect 2013;3:e105 ©2013 by The Journal of Bone and Joint Surgery, Inc.