Purpose <p>The purpose of the study is to evaluate the safety and efficacy of mini-fragment plate fixation of trochanteric fragments in Vancouver B2 femur fractures. Pre-contoured plates are generally used in the proximal femur of Vancouver B2 fractures to secure trochanteric fragments. However, stout pre-contoured plates are a potential source of symptomatic implants in a sensitive location, and alternatives such as mini-fragment fixation have not yet been reported.</p> Methods <p>In this case series, we retrospectively reviewed 5 patients who underwent operative treatment of Vancouver B2 periprosthetic femur fractures with locking mini-fragment plate fixation. Demographic and clinical variables were recorded for all patients. Outcome measures including post operative dislocation, infection, mortality, additional procedures, malunion or nonunion, fixation failure, time to ambulation, and instability were recorded and compared to historical alternatives, such as fixation with pre-contoured plates.</p> Results <p>No patients experienced fixation failure, nonunion or malunion, or underwent reoperation. One patient died postoperatively due to medical comorbidities. One patient developed mild hip pain around the implant postoperatively with no need for revision.</p> Conclusion <p>Mini-fragment plate fixation demonstrated no incidence of fixation failure or nonunion and is safe in the treatment of Vancouver B2 periprosthetic femur fractures. This technique represents a promising alternative in the management of Vancouver B2 periprosthetic femur fractures for surgeons hoping to avoid symptomatic implants without compromising fixation.</p>