Martín DG, Brito JLP, Casamayor SG, et al. - This study was intended to correlate stem revision vs internal fixation in the treatment of periprosthetic hip fractures (PPHF) with a loose stem. Researchers enrolled a total of 57 individuals (40 osteosyntheses and 17 stem revisions), with an average follow-up time of 3.1 years. Hospital stay, ASA, Charlson Comorbidity Index (CCI), surgery time, blood transfusion, complications, reoperation rate, first-year mortality, radiological and functional results were assessed. The data displayed that osteosynthesis requires less surgery time has a lower need for blood transfusions and a reduced hospital cost in comparison with stem revision. Stem revision remains the treatment of choice in PPHF with a loose stem, but osteosynthesis can be a viable option in V-B2 fractures in elderly patients with low functional demand, high anaesthetic risk (ASA ≥ 3), and many comorbidities (CCI ≥ 5) in whom anatomic reconstruction is possible.