title: Arthroplasty for Pertrochanteric Hip Fractures.
abstract: The mainstay of treatment of pertrochanteric fractures is internal fixation using a sliding hip screw or a cephalomedullary device. However, in patients with ipsilateral hip osteoarthritis or avascular necrosis of the femoral head, or inflammatory arthritis, arthroplasty should be considered as the primary treatment modality to reduce the likelihood of a secondary procedure. Unstable fracture patterns with concomitant poor bone quality represent a challenge for internal fixation, with high rates of lag screw cut-out and hardware failure. Prosthetic replacement for unstable pertrochanteric fractures has therefore been considered as an alternative primary treatment option. Further prospective randomized trials are required.
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada. Electronic address: tatu.makinen@hus.fi.
authors.forename: Tatu J
authors.initials: TJ
authors.lastname: Mäkinen
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gunton
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: Simcha G
authors.initials: SG
authors.lastname: Fichman
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: Aidin
authors.initials: A
authors.lastname: Kashigar
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
authors.affiliation: Division of Orthopaedic Surgery, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: Paul R T
authors.initials: PR
authors.lastname: Kuzyk
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D005593:Fracture Fixation, Internal; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D010027:Osteotomy
keywords: Hip arthroplasty; Ipsilateral hip osteoarthritis; Pertrochanteric fracture; Trochanteric slide osteotomy; Unstable hip fracture