title: Outcomes of modular proximal femoral replacement in the treatment of complex proximal femoral fractures: a case series.
abstract: BACKGROUND
  The treatment of complex femur fractures poses a significant challenge. Even with current advancements and the various implements available for the fixation of femoral fractures, results are often disappointing. This study sought to identify problems associated with and examine results of modular proximal femoral replacement. Outcomes were evaluated in two groups of patients: those receiving primary modular proximal femoral replacement for fractures and those treated with salvage arthroplasty for failed internal fixation.
  
  
  METHODS
  Twelve patients who had received modular proximal femoral replacement as primary treatment for proximal femoral fractures were evaluated along with nine patients treated with salvage proximal femoral replacement for failed internal fixation. After the surgical procedure, patients were evaluated at regular follow-up intervals and contacted by phone at the conclusion of this study. Patient functional results were evaluated using the Merle D'Aubigne hip rating scale, which measures pain, motion and ambulatory status. Routine radiographs were also obtained at each patient visit.
  
  
  RESULTS
  On average, patients who received modular proximal femoral replacement as the primary surgery for their femoral fractures enjoyed a high-level functional result and had few complications. Subjects who received salvage femoral replacement had a less optimal outcome and experienced more complications. Nonetheless, final post-operative MDA score was significantly increased from pre-operative levels.
  
  
  CONCLUSIONS
  Modular proximal femoral replacement is a viable option in the primary fracture or revision setting, and has been shown to have a reasonable outcome, especially when the nature of initial injury is taken into account.
authors.affiliation: Department of Orthopaedic Surgery, Northeastern Ohio Universities College of Medicine, Akron, OH 44302, USA. ajschoen@neoucom.edu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Schoenfeld
authors.forename: Mark C
authors.initials: MC
authors.lastname: Leeson
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Vrabec
authors.forename: Joseph
authors.initials: J
authors.lastname: Scaglione
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Stonestreet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019736:Prostheses and Implants; D011859:Radiography; D016879:Salvage Therapy; D017211:Treatment Failure