You raise several questions in your review. The answers to these could be found in most  decent post grad orthopaedic textbooks. From the radiograph the implant is positioned correctly - there is no surgical error in placement. The rarity of femoral prosthesis fracture would be against design fault. Should this proove to be a common problem an implant would be withdrawn and surgeons would be aware of this problem. The obese do not require different prostheses, again component selection can be read about in post grad books.

Case reports are just that. A report. They are not meant to be a systematic review of literature but a concise consideration of points raised by an intetresting or unusual presentation. Most surgical journals set a limit on the length of articles of 500 to 1000 words.

You may find the OrthoHyper guide or Wheeless' Textbook of Orthopaedics, both available free on the internet of interest.

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