title: Aggressive surgical treatment of periprosthetic femur fractures can reduce mortality: comparison of open reduction and internal fixation versus a modular prosthesis nail.
abstract: OBJECTIVE
  The purpose of this study was to determine if immediate full weightbearing after surgical treatment for periprosthetic femur fractures can decrease perioperative and total mortality.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Level II trauma center.
  
  
  METHODS
  Fifty-two consecutive patients with a periprosthetic femur fracture during a 16-year time period.
  
  
  METHODS
  Comparison 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).
  
  
  METHODS
  Six-month and total mortality using a Kaplan-Meier survival analysis. An additional matched subanalysis was performed for Vancouver Type B1 fractures.
  
  
  RESULTS
  Patients 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).
  
  
  CONCLUSIONS
  Treatment of periprosthetic femur fractures with femoral component exchange to a modular prosthetic nail that allows immediate postoperative full weightbearing may decrease mortality.
authors.affiliation: Department of Orthopaedic Surgery, HBH Klinikum Singen, Germany.
authors.forename: Ronny
authors.initials: R
authors.lastname: Langenhan
authors.forename: Per
authors.initials: P
authors.lastname: Trobisch
authors.forename: Pedro
authors.initials: P
authors.lastname: Ricart
authors.forename: Axel
authors.initials: A
authors.lastname: Probst
mesh_terms: D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005264:Femoral Fractures / Q000401:mortality* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000401:mortality*; D005858:Germany / Q000453:epidemiology; D006622:Hip Prosthesis; D006801:Humans; D010027:Osteotomy / Q000401:mortality*; D015995:Prevalence; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate