Periarticular fractures in elderly patients are challenging to manage because the fractures are typically comminuted and the bone is osteopenic, which often result in the failure of internal fixation. Patients who sustain these fractures demand immediate mobilization or they often do not recover their preinjury level of function. In geriatric patients, immediate arthroplasty provides an alternative to internal fixation for many periarticular fractures of the shoulder, elbow, and hip.