Hip Arthroplasty for failed internal fixation of intertrochanteric fractures.

Abstract

Introduction The purpose of this retrospective study was to asses the clinical and radiographics outcomes, complications as well technicals problems of hip arthroplasty following failure of dynamic screw fixation of the intertrochanterics fractures. Methods 38 hip arthroplasty in 38 patients were reviewed. There were 31 females and 7 males. The mean age was 75,59 (67-90) years and average follow – up was 45,5 (16-128) months. The prosthesis types included 30 total hip arthoplasties, 7 bipolar hip arthroplasties and one resection tumoral prothesis. Nine large femoral stems were used. Eleven uncemented cups and 20 cemented were used. We evaluated the presence of pain and objectively the Harris hip score (HSS) was used. Radiologically cementing quality, the appearance of a radiolucent line at the cement-stem interfase, the presence of loosening, nonunion of the greater trochanter and its complications was analyzed. Results Average Harris Hip Score was 79 (70-88) points. 30 of 35 cemented femoral stems were rated as Barrack A, 4 as B and 1 as C. There were no revisions for aseptic loosening. There were 5 nonunion of greater trochanter, 3 acutes infections, and 3 dislocations, one of them need reoperation. Conclusion Hip arthroplasty as salvage procedure after failed dynamic screw fixation is a satisfactory procedure with aceptable clinical outcomes and resumption of ambulation. This procedure is technically challenges with hight complications rate.

Keywords

• fractura intertrocantérica
• DHS
• osteosíntesis fallida
• Reemplazo de Cadera.Intertrochanteric fracture
• DHS
• failed internal fixation
• total hip arthroplasty.