Key result
Revision surgery for failed intertrochanteric fractures yields good functional outcomes with careful preoperative planning.
Careful preoperative planning for revision surgery of failed intertrochanteric fractures can lead to good functional outcomes.
May support planned revision for failed intertrochanteric fractures; leaves open need for prospective comparative trials.
Summary Revision surgery of failed intertrochanteric fractures is a challenging problem. The mode of failure is usually loss of fixation of the hardware with varus angulation and collapse at the fracture site. Concerns at the time of surgery include proximal femoral deformity, bone loss, compromised bone quality, and limb length discrepancy. Treatment options include revision internal fixation versus arthroplasty. The decision-making is primarily based on the status of the articular cartilage, the bone quality, and the activity level of the patient. Careful preoperative planning of the surgical procedure is extremely important and a good functional outcome can be anticipated in these patients.
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Malkani et al. (2002) conducted a review in Failed intertrochanteric fractures. Revision surgery (internal fixation or arthroplasty) was evaluated. Revision surgery for failed intertrochanteric fractures, utilizing internal fixation or arthroplasty, can yield good functional outcomes with careful preoperative planning.
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