title: When femoral fracture fixation fails: salvage options.
abstract: Most hip fractures treated with modern internal fixation techniques will heal. However, failures occasionally occur and require revision procedures. Salvage strategies employed during revision are based on whether the fixation failure occurs in the femoral neck, or in the intertrochanteric region. Patient age and remaining bone stock also influence decision making. For fractures in young patients, efforts are generally focused on preserving the native femoral head via osteotomies and repeat internal fixation. For failures in older patients, some kind of hip replacement is usually selected. Disuse osteopenia, deformity, bone loss, and stress-risers from previous internal fixation devices all pose technical challenges to successful reconstruction. Attention to detail is important in order to minimise complications. In the majority of cases, good outcomes have been reported for the various salvage strategies.
authors.affiliation: Orlando Regional Medical Center, Orlando health Orthopedic Institute, 1222 S Orange Ave, Orlando Florida 32806, USA.
authors.forename: J
authors.initials: J
authors.lastname: Petrie
authors.forename: A
authors.initials: A
authors.lastname: Sassoon
authors.forename: G J
authors.initials: GJ
authors.lastname: Haidukewych
mesh_terms: D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications; D003657:Decision Making; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010027:Osteotomy; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors; D016879:Salvage Therapy; D017211:Treatment Failure
keywords: Femoral fracture; Internal fixation; Salvage