Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur.
Background: Total hip replacement (THR) is one treatment option for failed hip fracture fixation. It is considered as a salvage procedure for older patients, patients with poor bone stock, avascular necrosis of the femoral head, associated with damaged acetabular articular cartilage. Patients an...
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2021-01-01
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doaj-353fd5f98b7142b1aacd97ee9fc9189d2021-02-02T19:37:18ZengAlbanian Society for Trauma and Emergency SurgeryAlbanian Journal of Trauma and Emergency Surgery2521-87782616-49222021-01-015110.32391/ajtes.v5i1.163Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur.Vilson Ruci0Edvin Selmani1Agron Dogjani2University of Medicine of Tirana, ALBANIAUniversity of Medicine of Tirana, ALBANIAUniversity of Medicine of Tirana, ALBANIA Background: Total hip replacement (THR) is one treatment option for failed hip fracture fixation. It is considered as a salvage procedure for older patients, patients with poor bone stock, avascular necrosis of the femoral head, associated with damaged acetabular articular cartilage. Patients and Methods: Total hip replacement was done for forty patients with failed internal fixation of trochanteric femoral fractures, 28 males and 12 females completed the follow up and six patients were lost. The procedure was carried out through a lateral exposure in all cases. Harris hip score (HHS) was used for clinical evaluation preoperatively, postoperatively. Radiographic evaluation comprising anteroposterior radiographic views of the pelvis and femur and a lateral view of the femur were performed at follow-up visits. Results: The mean time of follow up was 48 months (range from 36-72 months). The mean Harris hip score was improved from a mean of 24 points preoperative to 88 points at final follow up. Pain relief and gait correction were noted at the final follow up. Twenty-eight patients (70%) could freely walk outdoors using a cane or elbow crutch; eight patients (20 %) had a limited walking ability using two axillary crutches, and four patients (10 %) were able to walk indoors only. Conclusion: Total hip arthroplasty is a good salvage procedure after failed internal fixation of trochanteric femoral fractures. Individual selection of the implant depends upon the age of patient, level of activity, the bone stock of proximal femur, and the condition of the acetabulum. To maintain stability, reattachment of the greater trochanter should be done. To avoid intraoperative fractures of osteoporotic bone, dislocation of the hip should be very careful. https://journal.astes.org.al/index.php/AJTES/article/view/163total hipreplacementtrochanteric fracturefailure of fixation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vilson Ruci Edvin Selmani Agron Dogjani |
spellingShingle |
Vilson Ruci Edvin Selmani Agron Dogjani Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. Albanian Journal of Trauma and Emergency Surgery total hip replacement trochanteric fracture failure of fixation |
author_facet |
Vilson Ruci Edvin Selmani Agron Dogjani |
author_sort |
Vilson Ruci |
title |
Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. |
title_short |
Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. |
title_full |
Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. |
title_fullStr |
Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. |
title_full_unstemmed |
Salvage Total Hip Replacement after Failed Internal Fixation of Trochanteric Fracture Femur. |
title_sort |
salvage total hip replacement after failed internal fixation of trochanteric fracture femur. |
publisher |
Albanian Society for Trauma and Emergency Surgery |
series |
Albanian Journal of Trauma and Emergency Surgery |
issn |
2521-8778 2616-4922 |
publishDate |
2021-01-01 |
description |
Background: Total hip replacement (THR) is one treatment option for failed hip fracture fixation. It is considered as a salvage procedure for older patients, patients with poor bone stock, avascular necrosis of the femoral head, associated with damaged acetabular articular cartilage.
Patients and Methods: Total hip replacement was done for forty patients with failed internal fixation of trochanteric femoral fractures, 28 males and 12 females completed the follow up and six patients were lost. The procedure was carried out through a lateral exposure in all cases. Harris hip score (HHS) was used for clinical evaluation preoperatively, postoperatively. Radiographic evaluation comprising anteroposterior radiographic views of the pelvis and femur and a lateral view of the femur were performed at follow-up visits.
Results: The mean time of follow up was 48 months (range from 36-72 months). The mean Harris hip score was improved from a mean of 24 points preoperative to 88 points at final follow up. Pain relief and gait correction were noted at the final follow up. Twenty-eight patients (70%) could freely walk outdoors using a cane or elbow crutch; eight patients (20 %) had a limited walking ability using two axillary crutches, and four patients (10 %) were able to walk indoors only.
Conclusion: Total hip arthroplasty is a good salvage procedure after failed internal fixation of trochanteric femoral fractures. Individual selection of the implant depends upon the age of patient, level of activity, the bone stock of proximal femur, and the condition of the acetabulum. To maintain stability, reattachment of the greater trochanter should be done. To avoid intraoperative fractures of osteoporotic bone, dislocation of the hip should be very careful.
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topic |
total hip replacement trochanteric fracture failure of fixation |
url |
https://journal.astes.org.al/index.php/AJTES/article/view/163 |
work_keys_str_mv |
AT vilsonruci salvagetotalhipreplacementafterfailedinternalfixationoftrochantericfracturefemur AT edvinselmani salvagetotalhipreplacementafterfailedinternalfixationoftrochantericfracturefemur AT agrondogjani salvagetotalhipreplacementafterfailedinternalfixationoftrochantericfracturefemur |
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