Total hip arthroplasty (N=27) following failed internal fixation yielded results comparable to primary THA for femoral neck fractures, but less satisfactory for intertrochanteric fractures.
Observational (n=27)
What are the outcomes and complication rates of total hip arthroplasty following failed internal fixation of proximal femur fractures?
Total hip arthroplasty following failed internal fixation of intertrochanteric fractures carries a high risk of intraoperative complications and postoperative dislocations, requiring extreme surgical care and availability of reconstructive components.
A retrospective review was performed on 27 consecutive patients with total hip arthroplasty (THA) following failure of internal fixation of fractures of the proximal femur. The results were comparable to primary THA in femoral neck fractures. Considerably less satisfactory results were obtained in THA in intertrochanteric fractures. Bone loss and medial displacement of the femoral shaft led to high incidence of intraoperative complications and postoperative dislocations. Extreme care must be taken to avoid fracture and penetration of the femoral shaft. Autograft, allograft, or head and neck replacement components should be available for reconstruction of the difficult cases.
Mehlhoff et al. (1991) conducted an observational in Failed internal fixation of proximal femur fractures (n=27). Total hip arthroplasty (THA) was evaluated on Clinical outcomes and complications. Total hip arthroplasty (N=27) following failed internal fixation yielded results comparable to primary THA for femoral neck fractures, but less satisfactory for intertrochanteric fractures.