Proximal femoral fracture with bony ankylosis of the hip joint : Case report of difficult surgical treatment

Abstract

A78-year-old female patient sustained aleft-sided proximal femoral fracture due to a fall. Since childhood the patient had suffered from ankylosis of unknown origin in the ipsilateral hip joint. The recommended intramedullary osteosynthesis could restore the original status quo before the fracture. It needs less time in the operating room (OR) and includes a lower risk for intraoperative complications than a hip joint endoprosthesis. Arthroplasty can lead to asignificant improvement in mobility of the hip joint but requires more time in the OR for the surgical procedure and anesthesia time and includes ahigher risk for intraoperative and postoperative complications. The antetorsion angle of76° in this patient deviated extremely from the standard and made the intramedullary osteosynthesis for this type of fracture achallenge. Using improvised techniques led to aload-stable fracture treatment that ultimately led to asatisfactory result.