Journal of orthopaedic trauma · 1997
Total hip arthroplasty for complications of proximal femoral fractures.
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Tabsh I, Waddell J P, Morton J
Аннотация
OBJECTIVES: To determine problems associated with and to present the results of secondary total hip replacement for complications of proximal femoral fractures.
SETTING: An acute care hospital with a prospectively entered database for primary total hip arthroplasty.
PATIENTS AND PARTICIPANTS: The prospective database was reviewed to extract all patients undergoing primary total hip replacement for complications of treatment of proximal femoral fractures. These fifty-three patients were then compared with fifty-three patients from the same data bank matched for age, sex, weight, prosthesis type, and length of follow-up but who had not sustained a proximal femoral fracture before total hip replacement.
INTERVENTION: Primary total hip arthroplasty for complications of proximal femoral fractures. After the surgical procedure, patients were seen at follow-up intervals of three months and six months and, thereafter, yearly.
MAIN OUTCOME MEASUREMENTS: Patients were evaluated using the St. Michael's hip rating scale, which is a scale measuring pain, motion, and function specifically designed for evaluation of total hip arthroplasty. Routine radiographs were obtained at each patient visit.
RESULTS: The complications associated with total hip replacement in patients with previous proximal femoral fracture fixation occurred more frequently than in patients who had not had undergone previous fracture fixation; in addition, intraoperative surgical difficulty was significantly greater in those patients who had undergone previous surgery for hip fracture. However, the final hip score at > or = 2 years after total hip arthroplasty was not statistically different between the two patient groups.
CONCLUSION: Total hip replacement is a satisfactory salvage procedure for failed fracture treatment despite the increased incidence of operative difficulty and increased incidence of complication.
SETTING: An acute care hospital with a prospectively entered database for primary total hip arthroplasty.
PATIENTS AND PARTICIPANTS: The prospective database was reviewed to extract all patients undergoing primary total hip replacement for complications of treatment of proximal femoral fractures. These fifty-three patients were then compared with fifty-three patients from the same data bank matched for age, sex, weight, prosthesis type, and length of follow-up but who had not sustained a proximal femoral fracture before total hip replacement.
INTERVENTION: Primary total hip arthroplasty for complications of proximal femoral fractures. After the surgical procedure, patients were seen at follow-up intervals of three months and six months and, thereafter, yearly.
MAIN OUTCOME MEASUREMENTS: Patients were evaluated using the St. Michael's hip rating scale, which is a scale measuring pain, motion, and function specifically designed for evaluation of total hip arthroplasty. Routine radiographs were obtained at each patient visit.
RESULTS: The complications associated with total hip replacement in patients with previous proximal femoral fracture fixation occurred more frequently than in patients who had not had undergone previous fracture fixation; in addition, intraoperative surgical difficulty was significantly greater in those patients who had undergone previous surgery for hip fracture. However, the final hip score at > or = 2 years after total hip arthroplasty was not statistically different between the two patient groups.
CONCLUSION: Total hip replacement is a satisfactory salvage procedure for failed fracture treatment despite the increased incidence of operative difficulty and increased incidence of complication.