Better Functional Outcome of Salvage THA Than Bipolar Hemiarthroplasty for Failed Intertrochanteric Femur Fracture Fixation

Failure of intertrochanteric fracture fixation often occurs in patients who have poor bone quality, severe osteoporosis, or unstable fracture patterns. The purpose of this study is to compare the results of total hip arthroplasty (THA) with bipolar hemiarthroplasty as the salvage procedures for failed fixation of intertrochanteric fractures of the femur. Eighteen consecutive patients who were treated for failed intertrochanteric fracture fixation were reviewed retrospectively. The patients were divided into 2 groups of salvage procedures: THA (9 patients) and bipolar hemiarthroplasty (9 patients). In the THA group, mean Harris Hip Score (HHS), visual analog scale (VAS) score, and Salvati and Wilson score were 82.1, 0.9, and 31.3, retrospectively. In the bipolar hemiarthroplasty group, mean HHS, VAS score, and Salvati and Wilson score were 68.6, 3.1 and 25.1, retrospectively. Total hip arthroplasty was better than bipolar hemiarthroplasty treatment in HHS (P=.040), VAS score (P=.001), and Salvati and Wilson score (P=.033). There were no significant differences in hospital stay, operating time, and transfusion volume between the 2 groups. Total hip arthroplasty seems to be more reliable salvage procedure for failed intertrochanteric fracture fixation in functional outcome and pain relief.