title: Increased complication rate following conversion total hip arthroplasty after cephalomedullary fixation for intertrochanteric hip fractures: a multi-center study.
abstract: Cephalomedullary devices (CMN) have become an increasingly popular for treatment of intertrochanteric hip fractures compared to sliding hip screw and side plate (SHS) devices. Failed fixation is often treated with conversion total hip arthroplasty (THA). We performed a multi-institutional study in which 60 patients with SHS devices and 31 patients with CMN devices were converted to THA. Harris Hip Score improved from 41.6 preoperatively to 83.6 at final follow-up in the SHS group and from 41.6 to 78.6 in the CMN group, with no significant difference between the groups (P=0.23). However, the complication rate in converted CMN patients was significantly higher at 41.9% compared with 11.7% (P=0.001) in converted SHS patients. Prior fixation with CMN may be associated with significantly higher complication rates during conversion.
authors.affiliation: Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, New York, New York.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Pui
authors.forename: Mathias P
authors.initials: MP
authors.lastname: Bostrom
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
authors.forename: William
authors.initials: W
authors.lastname: Macaulay
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Padgett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D001860:Bone Plates / Q000009:adverse effects*; D001863:Bone Screws / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: cephalomedullary nail; complications; conversion total hip arthroplasty; intertrochanteric hip fracture; sliding hip screw device