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Hip Replacement after Hip Fracture

Bone fracture in young adults often heals in about six weeks. But the aging adult with bone loss or poor bone quality may not have the same result.

Hip fracture is a common problem in older adults. The thighbone (femur) has a wide area of bone just before it angles to the hip socket. On either side are two bumps called the lesser trochanter and greater trochanter. A break that forms a line between these two bumps is called an intertrochanteric fracture. Failed treatment of fractures in this part of the hip is the subject of this study.

Whenever possible the bone is allowed to heal on its own. Sometimes an attempt is made to repair the fracture. A metal plate with screws can be used to hold the bone together during the healing phase. This is called salvage with internal fixation. It can save the patient's bone.

However, the fracture may collapse if there is bone loss or poor bone quality. Total hip replacement is the next step. The authors of this study looked at the results and problems with hip replacement after salvage internal fixation.

They report that hip replacement is a good treatment option if earlier treatment of an intertrochanteric fracture fails in the older patient. Most of the patients got relief from pain and could get around much better. Before surgery, these patients had poor walking ability or were unable to walk at all. With the hip joint replacement, walking at home and in the community improved. Many patients could walk without support or by using a cane or walker.


George J. Haidukewych, MD, and Daniel J. Berry, MD. Hip Arthroplasty For Salvage of Failed Treatment of Intertrochanteric Hip Fractures. In The Journal of Bone and Joint Surgery. May 2003. Vol. 85-A. No. 5. Pp. 899-904.

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