Immediate Weight-Bearing Following Biplanar Plating of Periprosthetic Femoral Fractures

Purpose: Femoral fractures in geriatric patients have a high 1-year mortality rate. Early mobilization without restrictions and full weight-bearing in elderly periprosthetic femoral fractures may improve mortality, morbidity, and accelerate functional recovery. The purpose of this study was to evaluate periprosthetic femoral fractures treated with biplanar plating and early ambulation. Materials and Methods: We conducted a retrospective study of periprosthetic femoral fractures treated with biplanar plating and immediate weight-bearing over a 4-year period. All patients were treated with anatomic reduction and primary bone healing, with biplanar fixation through a single, lateral-based incision. The primary outcome was radiographic union. Secondary outcomes were preinjury level and postinjury level of functional independence and need for revision surgery. Results: Seven patients met the inclusion criteria. The average age was 79.7 (range, 63 to 88) years. The average follow-up period was 18 months. Bony union occurred in all patients after the index procedure, with no revision surgeries documented. Five patients (71%) returned to preoperative ambulatory status, and all patients returned to their preoperative living environment. Conclusion: Our study supports the possibility of immediate weight-bearing in geriatric periprosthetic femur fractures treated with anatomic reduction and biplanar plating through a single lateral-based incision, although additional studies are needed.