Early complications after surgery for periprosthetic femoral fractures: incidence, risk factors, and…

Cohort studyEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie· Aug 2026

Early complications after surgery for periprosthetic femoral fractures: incidence, risk factors, and clinical implications.

Nicolas Blum, Lise Chevassut, Grégoire Leclerc … Thomas Fradin

Orthopedic TraumaCohort studyClinical practiceQ2IF 2.0

A third of patients develop complications in the first month after periprosthetic fracture surgery.

Early complications after surgery for periprosthetic femoral fractures: incidence, risk factors, and clinical implications.

Nicolas Blum … Thomas Fradin

European journal of orthopaedic surgery & traumatology · Aug 2026 · Q2 in Orthopedics

Background

Despite high associated morbidity and mortality, data specifically focusing on early postoperative complications remain scarce.

Purpose

Periprosthetic femoral fractures (periprosthetic femoral fractures) are the second cause of revision surgery after total hip arthroplasty and occur predominantly in elderly, fragile patients.

Methods

A single-center retrospective study was conducted on 192 patients who underwent surgery for periprosthetic femoral fractures between January 2010 and April 2023.

n = 192 patients

Results

over a third of patients had a complication within the first postoperative month

75.4%

General

2.6%

Mechanical

6.3%

Septic (PJI)

More results

General complications were the most frequent (75.4%), predominantly pulmonary and urinary infections, leading to a 7.3% early mortality rate.

Mechanical complications occurred in 5 patients (2.6%) and periprosthetic joint infection (periprosthetic joint infection) in 12 patients (6.3%), with S. aureus responsible for 66.7% of infections.

More results

In multivariate analysis, preoperative infection was independently associated with early mortality (OR = 3.47; p = 0.01) and early periprosthetic joint infection (OR = 2.40; p < 0.001) in the ORIF group, while alcoholism was correlated with early mortality (OR = 1.70; p = 0.02).

“

Conclusion · 1 of 3

Early complications following periprosthetic femoral fractures surgery are frequent and severe, reflecting the extreme frailty of this patient population.

Conclusion · 2 of 3

Preoperative infection control and an individualized approach to postoperative weight-bearing appear as key modifiable factors to improve early outcomes.

Conclusion · 3 of 3

A multidisciplinary, patient-centered management strategy is essential in this complex surgical setting.

Early complications after surgery for periprosthetic femoral fractures: incidence, risk factors, and clinical implications.

Early complications after surgery for periprosthetic femoral fractures: incidence, risk factors, and clinical implications.

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