With the increasing frequency of hip arthroplasty we have to reckon with more periprosthetic fractures. A review of the literature reveals controversy about the operative treatment of such fractures. Their origin and classification and the appropriate diagnostic procedures are presented. The management includes conservative treatment, plate osteosynthesis – in some cases associated with a new, cemented, femoral shaft, and implantation of a tumor prosthesis. The postoperative treatment and preparation of patients for informed consent are discussed in some detail, and the particular problems that can be encountered in the preparation of expert reports are commented on.