Treatment of intertrochanteric fractures with primary and secondary arthroplasty in geriatric patients

Introduction: The purpose of the present study is the perioperative and early postoperative assessment of geriatric patients (age>70 years) who underwent hip arthroplasty following intertrochanteric fractures and patients who had failure after PFN (Proksimal Femoral Nail) and then underwent hip arthroplasty.

Methods: Of the 62 patients with osteoporosis (BMD<-2.5) and unstable pertrochanteric fracture between April 2012 and February 2017, 44 patients who had primary hip arthroplasty following fracture and 18 patients who had hip arthroplasty following PFN failure were included in the present study. Duration of operation, blood loss parameters, intraoperative and early postoperative complications, Harris hip scores, and Parker mobility scores were evaluated.

Results: Increased intraoperative (trochanter major fracture and death) and early postoperative complications (infection, long-term stay in the hospital), longer operation durations, and increased blood loss were observed in the group that underwent hip arthroplasty after fixation.

Conclusions: Cementless hip prosthesis after fixation failure in patients with unstable intertrochanteric fractures is an effective salvage procedure for this age group. It was concluded that the complication rates were not within the acceptable limits in arthroplasty after PFN and that it would be appropriate to re-evaluate PFN indications.