Modular S-ROM prosthesis for failed internal fixation of intertrochanteric fracture

Abstract

Objective To observe the outcomes of hip arthroplasty with modular S-ROM prosthesis for failed internal fixation of intertrochanteric fracture. Methods Fifteen patients who had been admitted for failed internal fixation of intertrochanteric fracture from January 2013 to May 2015 were reviewed retrospectively in this study. They were 9 men and 6 women, aged from 55 to 86 years (average, 72 years). Their primary internal fixation methods included dynamic hip screw (DHS) in 7 patients, proximal femoral nail anti-rotation (PFNA) in 5 and proximal femoral locking plate in 3. The causes for internal fixation failure were implant loosening in 5 patients, screw breakage in 6, and cutting-out of screws in 4. All the patients received hip arthroplasty with modular S-ROM prosthesis to treat their fracture nonunion or displacement. Harris hip scores were measured before operation and at the final follow-up. Results Their average operative time was 156 min (from 118 to 180 min) and average intraoperative blood loss 432 mL (from 230 to 700 mL). No fracture or neurovascular damage occurred during operation. The 15 patients were followed up for 13 to 35 months (mean, 24 months). Postoperative dislocation of the artificial joint happened in one patient and nonunion of the greater trochanter due to massive bone defects was observed in 2 patients. Follow-ups showed none of the patients had such severe complications as infection, deep vein thrombosis or peri-prosthesis fracture. At the last follow-up, 15 patients obtained Harris hip score of 90.6 (from 78 to 95), with 11 excellent, 3 good and one fair cases. Conclusion Hip arthroplasty with modular S-ROM prosthesis is a safe and effective treatment for failed internal fixation of intertrochanteric fracture. Key words: Arthroplasty, replacement, hip; Hip fractures; Fracture fixation, internal; Treatment failure