Revision surgery for failed internal fixation of trochanteric fractures

الملخص EN

Most intertrochanteric hip fractures usually heal with internal fixation.

If nonunion or delayed union due to early loss of fracture fixation occurs, the treatment options include 'revision of internal fixation or prosthetic replacement depending upon the presence or absence of an adequate bone sto ck and healthy hip joint.

Aim of the work, To determine causes of failure in previous surgery and evaluate the results of revision of internal fixation for salvage of failed internal fixation of trochanteric fractures.

Materials and Methods, 18 patients with trochanteric fractures who had initial internal fixation that failed were treated with revision of internal fixation.

Twelve of them were females and 6 males.

The mean age of the patients was 58 years (ranged, 45 - 65 years).

Implants used for revision internal fixation were as follows: Eleven by dynamic hip screw 135°, 6 by 95° condylar plate and one using repositioning osteotomy plate.

Cancellous bone grafting was used in 7 patients.

The results, 18 patients were followed up for 1 to 6 years with an average of 3 years The results were good in 16 of them.

Avascular necrosis of the femoral head and leg length discrepancy were recorded in 2 patients requiring further management by total hip replacement.

' Conclusions, although revision of surgery for failed internal fixation of trochanteric fractures is difficult; but in properly selected patients and techniques; it can provide a high rate of union and good clinical results with a lew rate of complications.