Acute Hip Arthroplasty for the Treatment of Intertrochanteric Fractures in the Elderly

Arthroplasty for intertrochanteric fractures in elderly patients may allow early weightbearing and avoid fixation failure. Clinical results are reviewed in a consecutive group of acute arthroplasties (5 hemiarthroplasties and 29 total hip arthroplasties) performed via the anterolateral approach for intertrochanteric fractures. Age averaged 80.2 years. Follow-up averaged 35 months for living patients. Twenty-six patients died during follow-up. Time to death averaged 3.5 years. Five hips, all total hip arthroplasties, required subsequent surgeries: four for dislocation and one revised for sepsis. Acute intertrochanteric fractures are associated with high early mortality. In this series, a 15% complication rate and high mortality rate at 12 years was associated with acute arthroplasty. Dislocation is higher than in primary total hip arthroplasty utilizing the same surgical approach. The results do not support routine use of arthroplasty in treatment of intertrochanteric hip fractures in the elderly. (Journal of Surgical Orthopaedic Advances 14(4):185–189, 2005)