Intertrochanteric fracture is a common fracture in elderly patients. Total hip arthroplasty (THA) is regarded as a salvage operation to restore hip joint function after fixation failure.

A new study published in the European Journal of Medical Research aimed to ascertain whether THA as salvage treatment—for failed internal fixation of hip joint fractures in elderly patients—could reduce hip pain and restore joint function.

This was a retrospective study that analyzed 18 geriatric patients with a mean age of 70.3 years, each with intertrochanteric fracture fixation failure, who were treated with THA from 2013-2016. Internal fixation treatments involved – proximal femoral nail anti-rotation in five patients; locking proximal femur plates in seven; and dynamic hip screws in six. All patients were treated with THA using biological acetabular prosthesis and hip arthroplasty (HA) coating skillet femoral prosthesis, with the greater trochanter fixed using wire or steel when necessary.

Overall, 15 patients completed follow-up periods ranging between 19 and 54 months – one patient died from pulmonary embolism; one died from pulmonary heart disease 1 year after surgery; and another patient withdrew for personal reasons. Among those who were followed-up, there were no joint infections, periprosthetic fractures or dislocations. The average Harris score increased significantly, from 32.68 ± 12.04 points before surgery to 91.08 ± 5.9 points at 24 months post-treatment. Additionally, the SF-36 Health Questionnaire scores were significantly increased.

Hence, it was inferred that THA as salvage treatment for failed internal fixation of intertrochanteric femoral fractures significantly reduced hip pain and restored joint function in elderly patients and conferred satisfactory early clinical outcomes.

Source: European Journal of Medical Research. 2019 Dec 27;24(1):39. doi: 10.1186/s40001-019-0398-1