• Ronny Langenhan, Per Trobisch, Pedro Ricart, and Axel Probst.
• Department of Orthopaedic Surgery, HBH Klinikum Singen, Germany.
• J Orthop Trauma. 2012 Feb 1;26(2):80-5.

ObjectivesThe purpose of this study was to determine if immediate full weightbearing after surgical treatment for periprosthetic femur fractures can decrease perioperative and total mortality.DesignRetrospective review.SettingLevel II trauma center.PatientsFifty-two consecutive patients with a periprosthetic femur fracture during a 16-year time period.InterventionComparison of open reduction and internal fixation with a plate (non- or partial postoperative weightbearing) versus stem exchange to a modular prosthesis nail (immediate full postoperative weightbearing).Main Outcome MeasurementsSix-month and total mortality using a Kaplan-Meier survival analysis. An additional matched subanalysis was performed for Vancouver Type B1 fractures.ResultsPatients permitted immediate postoperative full weightbearing had a significantly decreased total (P < 0.001) and 6-month mortality (P = 0.007). Subanalysis of patients with Vancouver Type B1 fractures also showed decrease in mortality, which was significant for total (P < 0.005) but not for 6-month mortality (P = 0.121).ConclusionTreatment of periprosthetic femur fractures with femoral component exchange to a modular prosthetic nail that allows immediate postoperative full weightbearing may decrease mortality.

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