[Primary treatment of unstable pertrochanteric femoral fractures using a head-neck prosthesis in elderly patients].

OBJECTIVE

Evaluation of the treatment of unstable pertrochanteric femoral fractures with a femoral head prosthesis in older patients.

DESIGN

Descriptive.

SETTING

University Hospital Nijmegen, the Netherlands.

METHOD: From January 1988 through December 1992, 15 patients with 15 unstable pertrochanteric femoral fractures were treated with a femoral head prosthesis and additional wiring of the trochanter. The group consisted of 11 women and 4 men with a mean age of 86 years. Two operations were secondary treatments after broken angled-plate fixation. The other 13 were primary treatments.

RESULTS

A stable fixation allowing weight-bearing was achieved in all cases. The operations were accompanied by high morbidity and mortality rates: 4 patients died within 3 months after surgery. One dislocation of the prosthesis occurred. Twelve fractures consolidated, pseudarthrosis of the greater trochanter occurred twice. Five patients regained their preoperative walking ability.

CONCLUSION

Femoral head prosthesis with additional wiring is an alternative with few mechanical complications in the treatment of unstable pertrochanteric femoral fractures.