Treatment of Displaced Intracapsular Hip Fractures With Total Hip Arthroplasty

McKinley, John; Robinson, C. M.

doi:10.2106/00004623-200211000-00016

Cited by 135 publications

(19 citation statements)

References 12 publications

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“…Despite this finding, Haidukewych and Berry 17 reported relatively few complications and good pain relief and function in their large series of salvage THA after failed IT fractures. By contrast, McKinley and Robinson 18 reported poor outcomes in their series of salvage THA for failed subcapital fractures. Our subanalysis of salvage THA for failed internal fixation for intertrochanteric fractures and intracapsular neck fracture did not demonstrate any difference in complication rate or clinical outcome.…”

Section: Discussionmentioning

confidence: 95%

Total hip arthroplasty following failed fixation of proximal hip fractures

Srivastav¹,

Mittal²,

Agarwal³

2008

Indian J Orthop

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Background:Most proximal femoral fractures are successfully treated with internal fixation but a failed surgery can be very distressing for the patient due to pain and disability. For the treating surgeon it can be a challenge to perform salvage operations. The purpose of this study was to evaluate the short-term functional outcome and complications of total hip arthroplasty (THA) following failed fixation of proximal hip fracture.Materials and Methods:In a retrospective study, 21 hips in 20 patients (13 females and seven males) with complications of operated hip fractures as indicated by either established nonunion or fracture collapse with hardware failure were analysed. Mean age of the patients was 62 years (range 38 years to 85 years). Nine patients were treated for femoral neck fracture, 10 for intertrochanteric (I/T) fracture and two for subtrochanteric (S/T) fracture of the hip. Uncemented THA was done in 11 cases, cemented THA in eight hip joints and hybrid THA in two patients.Results:The average duration of follow-up was four years (2-13 years). The mean duration of surgery was 125 min and blood loss was 1300 ml. There were three dislocations postoperatively. Two were managed conservatively and one was operated. There was one superficial infection and one deep infection. Only one patient required a walker while four required walking stick for ambulation. The mean Harris Hip score increased from 32 preoperatively to 79 postoperatively at one year interval.Conclusion:Total hip arthroplasty is an effective salvage procedure after failed osteosynthesis of hip fractures. Most patients have good pain relief and functional improvements inspite of technical difficulties and high complication rates than primary arthroplasty.

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Section: Discussionmentioning

confidence: 95%

Total hip arthroplasty following failed fixation of proximal hip fractures

Srivastav¹,

Mittal²,

Agarwal³

2008

Indian J Orthop

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“…Some other studies showed unsatisfactory results. McKinley and Robinson expressed poor results in their series of management of THA for failed subcapital fractures 26. Srivastav et al’s analysis of THA for failed internal fixation in intertrochanteric hip fractures and intracapsular neck fracture did not show any difference in adverse events rate or clinical results.…”

Section: Discussionmentioning

confidence: 98%

<p>Salvage of failed dynamic hip screw fixation of intertrochanteric fractures</p>

Taheriazam¹,

Saeidinia

2019

ORR

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Background and aimFailure of intertrochanteric fracture fixation can occur in patients with poor bone quality, extreme osteoporosis, or unstable fracture arrangement. Although hip replacement is a commonly successful process, it includes technical problems, such as implant removal, bone loss, low bone quality, nonunion of trochanter, and difficult surgical exposure. The goal of this study was to restore total hip replacement for failed intertrochanteric fractures to assess the outcomes.MethodsDuring April 2009 to October 2015, 203 patients (203 hips) underwent total hip arthroplasty through the direct lateral approach, as salvage of failed intertrochanteric fracture management by dynamic hip screw (DHS). The restoration process was done by a direct lateral approach (Hardinge) in all hips. The operation details, such as duration, blood transfusion volume, blood loss, and duration of hospital stay, were recorded. Modified Harris hip score (MHHS) was applied for assessment of clinical outcome before and after the operation, and during the follow-up.ResultsOverall, 112 patients were male (55.17%) and 91 patients (44.8%) were female and the mean of age was 72.58±10.60 years old. Average operation time was 93.96±10.72 minutes. The mean blood loss volume during the operation was 355.86±84.11 mL. The mean preoperative MHHS score was 39.55±6.74 (range: 30–50). The MHHS score improved to 90.55±2.24, 92.34±1.26, and 94.34±1.85 during the first, second, and final follow-up, respectively (P<0.0001). Infection was found in only two patients, who had undergone one stage revision and linear of the cup was exchanged. Total rate of complications during the follow-up was 4.92%.ConclusionThe current research was a large population study and indicated that sufficient functional outcome could be obtained by total hip replacement in geriatrics with failed intertrochanteric fractures. Therefore, well-performed hip replacement could be a suitable choice for restoring failed DHS in unsuccessfully managed intertrochanteric fractures in the elderly.

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“…[2] Literatür, proksimal femur kırıklarında başarısız osteosentez sonrası uygulanan kalça artroplastisinin, birincil uygulananlara göre fonksiyonel sonuçlarının daha kötü, sağkalımın daha kısa ve komplikasyon (özellikle dislokasyon ve enfeksiyon) oranlarının daha yüksek olduğunu işaret etmektedir. [21][22][23][24] McKinley ve Robinson [23] , kurtarma artroplastisini birincil total kalça artroplastisi ile karşılaştırdıkları 214 hastalık çalışmada kurtarma artroplasti grubunda birincil artroplasti grubuna göre önemli ölçüde daha yüksek bir çıkık oranı (%21'e karşı %8) ve daha fazla yüzeyel enfeksiyon bildirmişlerdir. Ayrıca, kurtarma grubunda fonksiyonel skor ve implant sağkalımının daha düşük olduğu görülmüştür (Şekil 2).…”

Section: Protez Replasman Tedavisiunclassified

Osteosentez başarısızlık ve yetmezliklerinde tedavi kriter ve yöntemleri

Basılgan¹,

Buyukkuscu²

2021

TOTBID

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FEMUR BOYUN KIRIKLARINDA TESPİT YETERSİZLİĞİ Tespit yetersizliği ve kaynamama, ayrılmış ya da ayrılmamış femur boyun kırıklarının tedavisi sonrasında görülen temel yetmezlik biçimidir. Bu iki problemi birbirinden ayırmak güçtür çünkü tespit sonrası çoğu ayrılmış kırığın iyileşmesi uzun zaman alır, bu da tespitin başarısızlığını artırır. Ayrılmamış kırıklarda insidans düşüktür ve tespitin başarısız olması nadir bir komplikasyondur. [4] Her iki komplikasyon da ayrılmış kırıkların redüksiyon ve tespitinden sonra daha sık görülür. Ayrılmış kırıklarda kaynamama ve/veya revizyon gerektiren tespit kusuru oranı %40'lara kadar varan seviyelerde bildirilmiştir. [5] Sloobegean ve ark., yaptıkları meta-analiz çalışmasında 60 yaşın altındaki hastalarda

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Treatment of Displaced Intracapsular Hip Fractures With Total Hip Arthroplasty

Cited by 135 publications

References 12 publications

Total hip arthroplasty following failed fixation of proximal hip fractures

Total hip arthroplasty following failed fixation of proximal hip fractures

<p>Salvage of failed dynamic hip screw fixation of intertrochanteric fractures</p>

Osteosentez başarısızlık ve yetmezliklerinde tedavi kriter ve yöntemleri

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