Total arthroplasty for acute hip fractures, early results of eleven cases

ABSTRACT

We treated eleven elderly patients who suffered traumatic injury to the hip causing fracture or fracture- dislocation by primary total hip arthroplasty. There were 4 males and 7 females whose age ranged from 54 to 71 years [mean=61.7]. The injuries encountered were six displaced subcapital fractures [Garden III and IV]; four Pipkin type [III] and [IV] posterior fracture-dislocation and one Seinsheimer type [IV] subtrochanteric fracture. We used 9 standard cemented, 1 long stem cemented and 1 cementless hip prosthesis, 3 acetabular re-enforcement rings were also used. Autologous bone graft was used in 3 cases to reconstruct acetabular defects and in 1 case to augment bone healing in subtrochanteric fracture. The follow up ranged from 18 to 36 months [mean=25.3], at 18 months the Harris hip score ranged between 38 and 85 [mean=66]. There were 2 cases of posterior dislocation, 2 cases of significant leg length discrepancy, 1 case of iliofemoral DVT and 1 case of significant intrapelvic cement intrusion. THA for acute hip fracture is a technically demanding procedure that yields higher complication rate but can give good clinical results and implant short term survival, nevertheless, it should be reserved for a well selected group of patients and should be done in specialized centers