EC Orthopaedics

Research Article Volume 17 Issue 1 - 2026

Early Unrestricted Weight-Bearing Using a Minimally Invasive “Span the Whole Femur” Technique for Periprosthetic Femoral Fractures

Jawaad Saleem1, Lena Al-Hilfi1, Hasan Mercalose1, Irrum Afzal2* and Sarkhell Radha1,2

1Croydon University Hospital, Croydon, London, United Kingdom

2South West London Elective Orthopaedic Centre, Dorking Road, Epsom, United Kingdom

*Corresponding Author: Irrum Afzal, South West London Elective Orthopaedic Centre, Dorking Road, Epsom, United Kingdom.
Received: December 22, 2025; Published: December 31, 2025




Background: Management of periprosthetic hip and knee fractures is challenging and is becoming more frequent due to an increasing population of arthroplasty patients. These injuries lead to considerable morbidity due to loss of fixation of the components, loss of bone stock, and subsequent functional deficits. They also lead to increased mortality and their management is associated with significant risk of complications. Various management options have been described in current literature to treat periprosthetic fractures.

Aim of the Study: The aim of this study is to demonstrate that a minimally invasive [MIS] “span the whole femur” surgical technique, used across all fracture types and hip and knee periprosthetic fractures, provides predictable clinical outcomes in a challenging patient cohort.

Material and Methods: This retrospective case series reviewed patients with periprosthetic femoral fractures managed by a single surgeon at a high-volume hospital between 2019 and 2022. All patients underwent operative fixation using a minimally invasive “span the whole femur” technique, and full and unrestricted weight-bearing was permitted postoperatively in all cases. Fracture patterns included periprosthetic fractures around hip and knee arthroplasties, interprosthetic fractures involving both hip and knee implants, and revision periprosthetic fracture fixation. In all cases, fixation was performed using the NCB® Zimmer Biomet Periprosthetic Femur Plate System. Patient demographic characteristics, intraoperative variables, and postoperative clinical and radiological outcomes were collected and analysed.

Results: Fifteen patients were included, with a mean age of 83 years (range 68-93). All fractures resulted from low-energy falls. All patients were allowed immediate unrestricted weight-bearing and were mobilised within 24 hours postoperatively. Radiological and clinical union was achieved in all patients within 12 months. One superficial wound infection occurred, with no deep infection or venous thromboembolism. Thirty-day mortality was 6.7%, and all surviving patients returned to their pre-injury place of residence.

Conclusion: The span the whole femur technique is a reliable method of treating complex periprosthetic fracture with predictable radiological and clinical outcomes. This technique allows early-unrestricted weight bearing, which may reduce postoperative complications.

Level of Evidence: IV.

 Keywords: Periprosthetic Facture; Hip; Knee; Trauma; Fracture; Femur, Plating; Minimally Invasive Technique

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Irrum Afzal., et al. “Early Unrestricted Weight-Bearing Using a Minimally Invasive “Span the Whole Femur” Technique for Periprosthetic Femoral Fractures”. EC Orthopaedics  17.1 (2026): 01-09.

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