Total hip arthroplasty for unstable intertrochanteric fractures with necrosis of the femoral head:a 7-year follow-up

Abstract

To discuss the result and long time follow-up of unstable intertrochanteric fracture combined with avascular necrosis of femoral head treated by total hip arthroplasty. From March 2008 to October 2014, 23 cases were enrolled and treated by total hip arthroplasty, including 10 males and 13 females, aged 59 to 82 years old with an average of(68.4±10.4) years old. There were 8 cases of type Ⅱa fractures, 6 cases of type Ⅱb fractures, 9 cases of type Ⅲ fractures according to Evans Classification. There were 3 cases of type Ⅱa, 3 cases of type Ⅱb, 9 cases of type Ⅲ, 8 cases type Ⅳaccording to Ficat Classification. The complications were recorded, the joint function was evaluated by Harris score and prosthesis survival rate was analysed. Postoperative complications occurred in 2 cases, one patient had acute periprosthetic infection 3 months after operation, and one patient had hip dislocation 3 months after operation. All 23 patients were followed up for 61 to 110 months with an agerage of (85.1±22.9) months. The Harris score at the final follow-up was 83 to 92 months with an average of(89.8±5.2) months, which was significantly different from that before operation (P<0.05). Imaging showed that all patients had bone healing of intertrochanteric fractures. The 7-year survival rate of prosthesis in 23 patients was 95.7%. The symptoms of unstable intertrochanteric fracture combined with avascular necrosis of femoral head could be solved by total hip arthroplasty, and the long time result was satisfied.