Factors affecting the management of failed internal fixation of trochanteric hip fractures with conversion to hip arthroplasty

Abdelazeem, Ahmed H.; Khaled, Sherif A.; Karim, Mahmoud Abdel; Abdelazeem, Hazem

doi:10.4103/1110-1148.209006

Factors affecting the management of failed internal fixation of trochanteric hip fractures with conversion to hip arthroplasty

Authors

10.4103/1110-1148.209006

Abstract

Purpose
Failed internal fixation of intertrochanteric fractures typically leads to profound functional disability and pain. Conversion hip arthroplasty in this situation is technically demanding. The purpose of this study was to evaluate the results, technical problems and complications, as well as the impact, of different factors on such procedure.
Patients and methods
From May 2009 to October 2011, 30 patients (23 female and seven male) with a mean age of 66 years (range: 50–90 years old) were included in the study. Total hip replacement was used in all cases. Cemented stems were most commonly used because of poor bone quality (standard length in 10, long stems in 14 and calcar replacing in two). Cementless standard length stems were used in four patients. The mean follow-up was 25 months (range: 12–33 months).
Results
A statistically significant improvement was found comparing preoperative and postoperative conditions (<0.05). When comparing different factors, the age was the only statistically significant factor affecting the functional outcome, denoting better results with patients younger than 65 years of age (=0.002). We had four intraoperative fractures, one postoperative fracture, three dislocations, a single case of infection and two cases of implant loosening.
Conclusion
Although conversion hip arthroplasty is technically demanding, it is associated with a high success rate with good functional outcome and pain relief especially in younger age groups.

Keywords