Conversion arthroplasty after failed dynamic hip screw fixation of intertrochanteric fractures

Background
Failed treatment of intertrochanteric fractures typically leads to profound functional disability and pain. Factors that guide the choice of salvage treatment include the anatomic site of nonunion, the quality of the remaining bone and articular surface, and patient factors (such as age and activity level).
Patients and methods
Between 2010 and 2013, 30 patients (seven women and 23 men) with a mean age of 60 years (range: 50–70 years) were treated at the Orthopedic Department of Beni Suef University, following failure of internal fixation with dynamic hip screw of intertrochanteric fracture, using prosthetic replacement (12 bipolar hemiarthoplasty and 18 total hip replacement). The average follow-up was 14 months (range: 3–26 months).
Results
At the end of follow-up, nine hips had excellent results, 11 had good result, five had fair results, and five had poor results according to Harris hip score.
Conclusion
Hip arthroplasty is an effective salvage procedure after the failed treatment of an intertrochanteric fracture in older patients.