title: Hip arthroplasty in failed intertrochanteric fractures in elderly.
abstract: BACKGROUND
  Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure.
  
  
  METHODS
  30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant.
  
  
  RESULTS
  The average followup was 20 months (range 6-48 months). Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup.
  
  
  CONCLUSIONS
  A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group.
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Javahir A
authors.initials: JA
authors.lastname: Pachore
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Vikram I
authors.initials: VI
authors.lastname: Shah
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Ashish N
authors.initials: AN
authors.lastname: Sheth
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Kalpesh P
authors.initials: KP
authors.lastname: Shah
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Dhiraj P
authors.initials: DP
authors.lastname: Marothi
authors.affiliation: Department of Orthopedics, Shalby Hospitals Ltd., Ahmedabad, Gujarat, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Puri
keywords: Failed intertrochanteric fracture; hip arthroplasty; trochanteric nonunion; trochanteric wiring