Intertrochanteric fracture of the ankylosed hip joint treated by a gamma nail: a case report

Abstract

We herein report a rare case of an intertrochanteric fracture complicated with an ankylosed hip joint in a 76-year-old man. Generally, operative treatment is performed for elderly people with intertrochanteric fractures to prevent general complications, maintain mobility, and release pain. However, intertrochanteric fractures of ankylosed hip joints are rare, and the optimal surgery for this condition is unknown. In addition, surgical fracture repair is challenging because unusual instability of the fracture site is suspected owing to the long lever arm of the lower extremity. Nevertheless, we successfully treated this rare fracture using a gamma nail, which may be a useful implant with which to treat this type of fracture if the status of the arthrodesed hip joint allows.

Figure 1

Anteroposterior radiograph showing an intertrochanteric fracture of the right hip joint that was ankylosed because of arthrodesis performed 56 years earlier.

Figure 2

CT imaging around the hip showing marked gluteus muscle atrophy.

Figure 3

Anteroposterior radiograph captured after the operation showing the intertrochanteric fracture stabilized with a gamma nail.

Figure 4

Anteroposterior radiograph captured 8 months after the operation showing strong bone union.

Figure 5

Anteroposterior radiograph after the operation showing the important points of operation for an intertrochanteric fracture of an ankylosed hip, represented with five circles (a–e).