Total hip arthroplasty following failure of dynamic hip screw fixation of fractures of the proximal femur

Abstract

Thirty-two patients (11 male, 21 female) with a mean age of 64 years were prospectively studied after undergoing total hip replacement after failed treatment of intertrochanteric fractures. One patient had bilateral surgery. The mean time from primary surgery to the salvage arthroplasty was 15 months (range, 4 to 32 months). The mean follow-up period was 57 months (range, 30 to 108 months). Intraoperative femoral fracture occurred in one patient and postoperative dislocation in another. Three patients had deep venous thrombosis, two had gastrointestinal bleeding and one had a non fatal pulmonary embolism. At the last follow-up, we were able to review 26 patients with 27 arthroplasties; the other 6 patients had died. The majority had good pain relief and marked functional improvement. Twenty-two patients had either no or mild pain and 24 patients were able to walk freely with or without support. Almost 78% of patients had either excellent or good clinical results based on Harris hip score. Heterotopic ossification was noted in 8 hips. Total hip arthroplasty was found in this study to be an effective salvage procedure after failed treatment of intertrochanteric fracture in elderly patients.