BMC Musculoskeletal Disorders (Apr 2025)

Outcomes of non-operatively managed Vancouver Type B1 periprosthetic femur fractures: a multi-center retrospective cohort study

  • Mitchell Crebert,
  • Michael Le,
  • Geoff Murphy,
  • Annamaria Frangos Young,
  • Robert Molnar,
  • Daniel Franks,
  • Michael Symes,
  • Maurice Guzman

DOI
https://doi.org/10.1186/s12891-025-08535-w
Journal volume & issue
Vol. 26, no. 1
pp. 1 – 7

Abstract

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Abstract Background This retrospective case series evaluated mortality outcomes in patients with Vancouver B1 periprosthetic fractures (PPFs) managed non-operatively using a matched cohort approach. We hypothesize that mortality rates will not significantly differ between operative and non-operative management of Vancouver B1 PPFs, as treatment decisions are likely driven by fracture complexity and patient comorbidities rather than a direct survival benefit of surgical intervention. Methods Thirty patients with Vancouver B1 PPFs managed non-operatively between 2011 and 2017 across five major Australian trauma centers were identified. Patients were propensity-matched to 60 operatively managed patients, matched by age, ASA score, length of stay, follow-up duration, and fracture sub-type (B1). Mortality rates at 30 days, 1 and 5 years were compared between the non-operative and operatively managed groups. For the non-operative group alone, the impact of weight-bearing status on mortality was assessed. Results There was no significant difference in mortality rates between the non-operative and operative cohorts at 30-day (3.3%; 1.7%; P = 1.00), 1 year (20.0%; 3.3%; P = 0.09) and 5 years (33.3%; 30.0%; P = 0.78). For the non-operative group alone, there was no significant difference in mortality rates between WBAT and non-WBAT groups at 30 days (7.7%; 0.0%; P = 0.400), 1 year (15.4%; 17.6%; P = 0.839) and 5 years (30.8%; 35.3%; P = 0.781), Conclusion Comparable 5-year mortality rates were identified between non-operatively and operatively managed Vancouver Type B1 periprosthetic femoral fractures. Despite differences in age and comorbidities, non-operative management may be a viable option for selected patients, underscoring the need for further research to refine treatment guidelines. Clinical trial number Not applicable.

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