Femoral shaft fractures following hip arthroplasty can be difficult to manage, particularly in elderly patients. Nine patients were treated with open reduction and rigid internal fixation using cement augmentation for screw fixation in the distal shaft. The stability achieved allowed all patients to be mobilized in the immediate postoperative period. No incidences of reduction loss or implant failure occurred, and all fractures had healed by the time of review. The results obtained support this method of treatment for ipsilateral femoral shaft fractures when prosthetic stability has not been compromised.