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)
Key words: dislocation, hemiarthroplasty, hip fracture, intertrochanteric hip fracture, total hip

Keith R. Berend, MD; Joseph Hanna, MD; Thomas M. Smith, DO; Thomas H. Mallory, MD, FACS; and Adolph V. Lombardi, Jr., MD, FACS