Acta Ortopédica Mexicana

Longoria MEV, Hernández RC, Lira RJM
Arthroplasty after failed osteosynthesis in hip fractures
Acta Ortop Mex 2007; 21 (6)

Language: Español
References: 18
Page: 323-327
PDF: 131.49 Kb.

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Objective: To assess the functional status of patients with arthroplasty after failed osteosynthesis in hip fractures. Material and methods: Prospective, descriptive, cohort of patients with primary failed osteosynthesis in hip fracture, who underwent total arthroplasty in the period 2002-2004, analyzed with the Harris functional scale. Results: 26 patients: 17 women and 9 men, mean age of 74.8 years. Seventeen patients had loosening of dynamic hip screw, 5 of condylar screw 5 and 4 with cannulated screws. We made 12 hybrid, 10 cemented and 4 not cemented arthroplasties. Eighteen patients with good results, 7 with regular and 1 bad result. Patients with the highest rating were the youngest. Discussion: Arthroplasty of the hip in a patient with failed osteosynthesis should be considered necessary. If we can improve pain of the hip, the patient will have less functional limitation and a better quality of life. This type of surgery requires high technical capability and experience by the orthopedic surgeon. Conclusions: Hip arthroplasty after failed osteosynthesis in hip fractures is a method that improves function and a gives a better life quality.

Key words: prosthetics, pain, osteosynthesis, hip, evaluation.


  1. Parker MJ: The management of intracapsular fractures of the proximal femur. J Bone Joint Surg Br 2000; 82(7): 937-41.

  2. Ahrengart, et al: A randomized study of the compression hip screw and gamma nail in 426 fractures. Clin Orthop Rel Res 2002; (401): 209-22.

  3. Curtis MJ, et al: Proximal femoral fracture a biomechanical study to compare intramedullary vs extramedullary fixation. Injury 1994; 25: 99-104.

  4. Kyle RF, Gustilo RB, Premer RF: Analysis of six hundred and twenty-two intertrochanteric hip fractures. J Bone Joint Surg Am 1979; 61(2): 216–21.

  5. Alberts KA, Jervaeus J: Factors predisposing to healing complications after internal fixation of femoral neck fracture. Clin Orthop Rel Res 1990; (257):129-33.

  6. Baker HR, et al: Ununited intertrochanteric fracture of the femur. Clin Orthop Rel Res 2000; 18: 209-20.

  7. Mariani EM, et al: Nonunion of intertrochanteric fractures of the femur following open reduction and internal fixation. Results of second attempts to gain union. Clin Orthop Rel Res 1987; (218): 81-9.

  8. McKinley JC, et al: Treatment of displaced intracapsular hip fractures with total hip arthroplasty: comparison of primary arthroplasty with early salvage arthroplasty after failed internal fixation. J Bone Joint Surg Am 2002; 84(11): 2010-5.

  9. Franzen H, Nilsson LT, Stromqvist B, Johnsson R, Herrlin K: Secondary total hip replacement after fractures of the femoral neck. J Bone Joint Surg Br 1990; 72: 784-7.

  10. Mehlhoff T, Landon GC, Tullos HS: Total hip arthroplasty following failed internal fixation of hip fractures. Clin Orthop Rel Res 1991; (269): 32–7.

  11. LaBelle LW, Colwill JC, Swanson AB: Bateman bipolar hip arthroplasty for femoral neck fractures. A five- to ten-year follow-up study. Clin Orthop Rel Res 1990; (251): 20–5.

  12. Tabsh I, Waddell JP, Morton J: Total hip arthroplasty for complications of proximal femoral fractures. J Orthop Trauma 1997; 11: 166–9.

  13. Haentjens P, Casteleyn PP, Opdecam P: Hip arthroplasty for failed internal fixation of intertrochanteric and subtrochanteric fractures in the elderly patient. Arch Orthop Trauma Surg 1994; 113: 222–7.

  14. Patterson BM, Salvati EA, Huo MH: Total hip arthroplasty for complications of intertrochanteric fracture. A technical note. J Bone Joint Surg Am 1990; 72: 776–7.

  15. Harris WH, Sledge CB: Total hip and total knee replacement (2). N Engl J Med 1990; 323: 801-7.

  16. Harris WH: Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty; an end-result stage using a new method of result evaluation. J Bone Joint Surg 51A (1969): 737-55.

  17. Arthur L. Malkani, Revision fixation for failed intertrochanteric fractures. Tech Orthop 2003; 17(4): 443-7.

  18. Müller ME, Indication, preoperative planning, technique in Schatzker J. ed. The Intertrochanteric osteotomy New York Springer- Verlag; 1984: 34-40.