title: Management of failed trochanteric fracture fixation with cementless modular hip arthroplasty using a distally fixing stem.
abstract: Failure of internal fixation of intertrochanteric fractures is associated with delayed union or malunion resulting in persistent pain and diminished function. We evaluated 15 elderly patients treated with a tapered, fluted, modular, distally fixing cementless stem. At an average follow-up of 2.86 years, mean Harris hip score improved from 35.90 preoperatively to 83.01 (P < .01). Fourteen stems had stable bony on growth, and one stem was loose. Distal fixation with a tapered, fluted, modular cementless stem allows stable fixation with good functional outcome in a reproducible fashion in this challenging cohort of patients.
authors.affiliation: Department of Orthopedic Surgery, Lenox Hill Hospital, NewYork, NY, USA.
authors.forename: Raman R
authors.initials: RR
authors.lastname: Thakur
authors.forename: Ajit J
authors.initials: AJ
authors.lastname: Deshmukh
authors.forename: Amrit
authors.initials: A
authors.lastname: Goyal
authors.forename: Amar S
authors.initials: AS
authors.lastname: Ranawat
authors.forename: Vijay J
authors.initials: VJ
authors.lastname: Rasquinha
authors.forename: Jose A
authors.initials: JA
authors.lastname: Rodriguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome