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HIP
Year : 2004  |  Volume : 38  |  Issue : 3  |  Page : 147-150

Hip arthroplasty following failed dynamic hip screw fixation for per-trochanteric femoral fractures


1 Orthopedics & Joint Replacement Institute, India
2 Max Healthcare, New Delhi, India

Correspondence Address:
SKS Marya
1193A, Sector B-1, Vasant Kunj, New Delhi - 110070
India
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Source of Support: None, Conflict of Interest: None


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Background: Unstable trochanteric fractures have a poor outcome in patients in whom fixation fails and revision to a total hip arthroplasty is required. The primary indication for secondary surgery is relief of pain. Method: A retrospective review was performed on 17 patients with hip arthroplasty following failure of dynamic hip screw fixation done for per-trochanteric femoral fractures. Three patients underwent bipolar hip arthroplasty and total hip replacement in the remaining fourteen. Results: Clinical and radiological results at final follow up were equally good following bipolar or total hip arthroplasty conversions. Extreme care needs to be taken to avoid fracture and penetration of the femoral shaft. Auto graft, allograft or head and neck replacement components should be made available for reconstruction of difficult cases. Conclusion: The principles of a successful outcome include preservation of the functional continuity of the abduction apparatus during surgery, and early supervised weight bearing.


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