Hip arthroplasty for failed internal fixation of intertrochanteric fractures
10.3760/cma.j.issn.0253-2352.2011.07.011
- VernacularTitle:髋关节置换术治疗股骨转子间骨折内固定失败
- Author:
Zhongtang LIU
;
Xiaoyun PAN
;
Qi WANG
;
Yunsu CHEN
;
Yao JANG
;
Xianlong ZHANG
;
Changqing ZHANG
;
Bingfang ZENG
- Publication Type:Journal Article
- Keywords:
Arthroplasty,replacement,hip;
Hip fractures;
Treatment failure
- From:
Chinese Journal of Orthopaedics
2011;31(7):784-788
- CountryChina
- Language:Chinese
-
Abstract:
Objective To respectively analyze the results and complications of hip arthroplasty for failed intertrochanteric hip fractures treating with internal fixation.Methods From July 2004 to June 2006,32 patients(24 males and 8 females)were treated with hip arthroplasty after the failed internal fixation of intertrochanteric fractures.The mean age was 71 years(range,57-81 years)at the time of the hip arthroplasty.The average interval from fracture to arthroplasty was 40 months(range,5-70 months).Fifteen patients had been treated with sliding hip screw,10 with intramedullary nail,5 with plate and screws,2 with multiple screws.The failure modes were nonunion in 8 patients,implant cut out from the femoral head in 9,avascular necrosis of the femoral head in 7,and traumatic arthritis in 8 patients.Cemented stems were used in 12 hips,and uncemented stems in 20 hips.Standard prostheses were used in 25,long-stem prostheses in 7.Results Twenty-eight patients were followed up for a minimum of 4 years after the hip arthroplasty,with the mean period of 5 years(range,4-6 yeas).For these 28 patients,the average preoperative Harris Hip Score was 37(range,32-45),and 88(range,84-95)at the latest follow-up.The average acetabular inclination was 44°(range,42°-48°).No loosing was found in cotyloid components.Nine of 10 cemented femoral components had cementation rated as grade C,and 1 as grade A.Three had heterotopic bone six months postoperatively,and 2 were Brooker type Ⅱ,one was type Ⅲ.Conclusion Hip arthroplasty is an effective salvage procedure after the failed treatment of an intertrochanteric fracture in an older patient.
