title: Primary prosthetic replacement in per- and intertrochanteric fractures.
abstract: OBJECTIVE
  Hip arthroplasty is rarely indicated in the treatment of per- and intertrochanteric femur fractures. Although the majority of fractures are amenable to closed- or open reduction and internal fixation (CRIF/ORIF), in some patients the complexity of the fracture or other patient-related factors may cause the orthopaedic surgeon to consider arthroplasty as the treatment of choice. Decision-making is challenging, and a reliable score has not yet been established.
  
  
  RESULTS
  Reviewing literature, several predictors of inferior outcome after CRIF/ORIF in per- and intertrochanteric fractures such as age, gender, poor bone quality, hip osteoarthritis, operation time and postoperative weight-bearing restrictions have been identified. Based on the literature review, a novel Hamburg Per- and Intertrochanteric Fracture Score (HPIFS) is proposed to support decision-making for per- and intertrochanteric fracture treatment.
  
  
  CONCLUSIONS
  CRIF/ORIF remain the workhorses in per- and intertrochanteric fracture management. Arthroplasty offers an advantageous treatment option for a well-defined patient and fracture collective. The HPIFS might support the decision-making process.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. mi.hoffmann@uke.de.
authors.forename: M
authors.initials: M
authors.lastname: Hoffmann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hartel
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Rueger
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Lehmann
keywords: Arthroplasty; Pertrochanteric intertrochanteric fracture; Score; Treatment algorithm
references.citation: J Bone Joint Surg Br. 1992 May;74(3):329-31
references.pmid: 1587869
references.citation: N Engl J Med. 1996 Jun 6;334(23):1519-25
references.pmid: 8618608
references.citation: Unfallchirurg. 2003 Jan;106(1):39-47
references.pmid: 12552392
references.citation: J Arthroplasty. 2005 Jun;20(4):414-20
references.pmid: 16124955
references.citation: Clin Orthop Relat Res. 2000 Feb;(371):206-15
references.pmid: 10693568
references.citation: J Bone Joint Surg Am. 1998 May;80(5):618-30
references.pmid: 9611022
references.citation: Unfallchirurg. 1989 May;92(5):234-9
references.pmid: 2740921
references.citation: Int Orthop. 2002;26(4):233-7
references.pmid: 12185526
references.citation: J Bone Joint Surg Am. 2005 Oct;87(10):2186-92
references.pmid: 16203881
references.citation: J Bone Joint Surg Am. 1994 Jan;76(1):15-25
references.pmid: 8288658
references.citation: Arch Orthop Trauma Surg. 2007 Dec;127(10):959-66
references.pmid: 17899138
references.citation: J Bone Joint Surg Am. 1989 Sep;71(8):1214-25
references.pmid: 2777850
references.citation: J Bone Joint Surg Br. 1991 Mar;73(2):330-4
references.pmid: 2005167
references.citation: J Arthroplasty. 2005 Apr;20(3):337-43
references.pmid: 15809952
references.citation: Clin Orthop Relat Res. 1987 May;(218):81-9
references.pmid: 3568500
references.citation: J Orthop Trauma. 2005 Apr;19(4):229-33
references.pmid: 15795570
references.citation: J Arthroplasty. 2005 Dec;20(8):963-6
references.pmid: 16376248
references.citation: Orthopade. 2006 Jun;35(6):651-7
references.pmid: 16557396
references.citation: J Orthop Trauma. 2002 Jul;16(6):386-93
references.pmid: 12142826
references.citation: J Bone Joint Surg Am. 1979 Mar;61(2):216-21
references.pmid: 422605
references.citation: Int Orthop. 2006 Apr;30(2):69-78
references.pmid: 16496147
references.citation: J Bone Joint Surg Am. 2004 Oct;86-A(10):2263-7
references.pmid: 15466737
references.citation: J Orthop Trauma. 2000 Nov;14(8):546-53
references.pmid: 11149500