title: Clinical outcome of endoprosthetic replacement for failed treatment of intertrochanteric fractures: A retrospective case series.
abstract: OBJECTIVE
  The treatment methods for the failed internal fixation in elderly patients suffering from several osteoporostic fractures are still inconclusive. We aimed to evaluate the clinical effects of endoprosthetic replacement for failure treatment of intertrochanteric fracture.
  
  
  METHODS
  A total of 13 patients with failed internal fixation for intertrochanteric fracture were collected between January 2002 and October 2009. All of them were treated with endoprosthetic replacement and followed up till October 2010. Four of them received total hip replacement and the remained nine received artificial bipolar femoral head replacement. Clinical and functional outcomes of patients were assessed.
  
  
  RESULTS
  Of 13 patients, nine were females and four were males with the mean age of 76.5 years (SD, 11.7, range, 58-92 years) at the time of fracture. The average time of operation and follow-up was 124 minutes (89-187minutes) and 31 months (14-68 months), respectively. The average blood loss during the operation was 631 ml (450-1560 ml). All patients showed good pain relief and functional improvement. Final post-operative Harris and WOMAC scores were significantly improved from pre-operative levels (P<0.05). Only five patients showed operative complications.
  
  
  CONCLUSIONS
  Our finding indicated that endoprosthetic replacement is an effective salvage procedure for failed internal fixation of intertrochanteric fracture in elderly patients with effective pain relief and functional improvement as well as few serious complications.
authors.affiliation: Wei Feng, Department of Orthopedics, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Feng
authors.affiliation: Ting Hao, Department of Orthopedics, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Hao
authors.affiliation: Wan-lin Liu, Department of Pediatric Orthopedics, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China.
authors.forename: Wan-Lin
authors.initials: WL
authors.lastname: Liu
authors.affiliation: Yan-fei Jia, Department of Orthopedics, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China.
authors.forename: Yan-Fei
authors.initials: YF
authors.lastname: Jia
authors.affiliation: Zeng-tao Hao, Department of Orthopedics, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China.
authors.forename: Zeng-Tao
authors.initials: ZT
authors.lastname: Hao
authors.affiliation: Sheng-Bin Bai, Department of Anatomy & Neurobiology, Xiangya School of Medicine, Central South University, 78 Xiangya Road, Changsha, China.
authors.forename: Sheng-Bin
authors.initials: SB
authors.lastname: Bai
keywords: Endoprosthetic replacement; Failure treatment of intertrochanteric fracture; Functional assessment