Hassan, K., Soudy, E., Elzohairy, M., Atia, A. (2020). Total Hip Arthroplasty after Failed Internal Fixation of Neck Femur Fracture: Analysis of 12 Cases. The Egyptian Journal of Hospital Medicine, 81(7), 2429-2432. doi: 10.21608/ejhm.2020.133958
Khaled Mohammed Hassan; Elsayed Eletewy Soudy; Mohamed Mansour Elzohairy; Ahmed Mohammed Fathy Atia. "Total Hip Arthroplasty after Failed Internal Fixation of Neck Femur Fracture: Analysis of 12 Cases". The Egyptian Journal of Hospital Medicine, 81, 7, 2020, 2429-2432. doi: 10.21608/ejhm.2020.133958
Hassan, K., Soudy, E., Elzohairy, M., Atia, A. (2020). 'Total Hip Arthroplasty after Failed Internal Fixation of Neck Femur Fracture: Analysis of 12 Cases', The Egyptian Journal of Hospital Medicine, 81(7), pp. 2429-2432. doi: 10.21608/ejhm.2020.133958
Hassan, K., Soudy, E., Elzohairy, M., Atia, A. Total Hip Arthroplasty after Failed Internal Fixation of Neck Femur Fracture: Analysis of 12 Cases. The Egyptian Journal of Hospital Medicine, 2020; 81(7): 2429-2432. doi: 10.21608/ejhm.2020.133958
Total Hip Arthroplasty after Failed Internal Fixation of Neck Femur Fracture: Analysis of 12 Cases
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University
Abstract
Background: There are different indications for total hip arthroplasty (THA) after failed internal fixation of neck femur fracture. This led us to carry out a prospective study of the clinical outcomes, radiological outcomes, technical issues and complications of this procedure. Objective: To evaluate the clinical and radiological outcome of total hip arthroplasty after failed internal fixation of neck femur fracture, along with the technical difficulties and complications encountered. Patients and methods: This was a prospective, single-center study of 12 THA cases performed after internal fixation of neck femur fracture. These procedures were performed between 2017 and 2019 in 12 patients (5 men, 7 women). The initial fracture fixation involved a screw-plate (n = 1), intramedullary nail (n = 2) or screws (n = 9). The mean patient age at the time of THA was 50 years [38–72]. The THA was performed an average of 2.8 years [0.2–28] after the fracture. The lateral (Modified Hardinge) hip approach was used in all cases. 3 patients (25%) had the fixation hardware removed before the THA procedure. During the THA procedure, a cemented stem was used in 4 cases (33.3%) and a cement less stem in 8 cases (66.7%). A cement less press-fit cup was used in all cases. Results: No patients were lost to follow-up. Two patients suffered an intraoperative femur fracture (16.7%) and one suffered a dislocation (8.3%). One hip had to be reoperated (8.3%) and required an implant change. With a mean follow-up of 36 months [12–48], the mean modified Harris hip score was 78.2 ± 4.4 [35-91]. Conclusion: THA is a satisfactory salvage procedure after failed internal fixation of neck femur fracture.
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