Salvage hip arthroplasty and revision osteosynthesis are the two main treatment options for failed IT fractures. Salvage hip arthroplasty includes total hip arthroplasty and hemiarthroplasty. 12,13 Many technical challenges one must overcome before doing revision procedures, like poor bone stock, residual bone deformity, removable of broken implant, altered soft tissue anatomy after primary fixation, and proximal femoral deficiency. Due to these technical challenges, revision surgeries
IntroductIonIntertrochanteric (IT) fracture of the hip is mostly seen in the elderly osteoporotic population. It comprises half of the hip fractures and creates a great burden to the treating surgeon and the patient. [1][2][3] These fractures are more common in females when compared with males due to postmenopausal decrease in bone density. The ratio is 2:1-8:1, with female predominance. 4 The surgical options are either intramedullary fixation and extramedullary fixations like sliding slip screws or proximal femoral locking plating. 5 Despite the controversy of using fixation devices, intramedullary fixations are the choice of implants because of their superior advantages. 6 Changes in implant design and reduction methods are made to achieve stability of the fracture. Although it is treated with the above fixations, the fixation failure rate ranges from 3 to 12%. [7][8][9] Fracture pattern, preexisting chronic comorbidities, and bone density are some factors that determine the fracture union. Failed IT fractures can cause significant pain and disability and always needs surgery. 10 Indications for surgery are nonunion, malunion, implant failure, refracture, dislocations, femoral head necrosis, and infection. 11