Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art
Abstract Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03593-8 |
| _version_ | 1818259262954012672 |
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| author | Pei Liu Dongxu Jin Changqing Zhang Youshui Gao |
| author_facet | Pei Liu Dongxu Jin Changqing Zhang Youshui Gao |
| author_sort | Pei Liu |
| collection | DOAJ |
| description | Abstract Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish a profound strategy for the effective surgical management of these fragile patients. Salvage options are determined according to patient physiological age, functional level, life expectancy, nonunion anatomical site, fracture pattern, remaining bone quality, bone stock, and hip joint competency. In physiologically young patients, care should be taken to preserve the vitality of the femoral head with salvage internal fixation; however, for the elderly population, conversion arthroplasty can result in early weight bearing and ambulation and eliminates the risks of delayed fracture healing. Technical challenges include a difficult surgical exposure, removal of broken implants, deformity correction, critical bone defects, poor bone quality, high perioperative fracture risk, and prolonged immobilization. Overall, the salvage of failed internal fixations of IT fractures with properly selected implants and profound techniques can lead to the formulation of valuable surgical strategies and provide patients with satisfactory clinical outcomes. |
| first_indexed | 2024-12-12T18:12:39Z |
| format | Article |
| id | doaj.art-9a5b3e465dee4149863dbcf9e25b6bf5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-12T18:12:39Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-9a5b3e465dee4149863dbcf9e25b6bf52022-12-22T00:16:20ZengBMCBMC Musculoskeletal Disorders1471-24742020-08-012111810.1186/s12891-020-03593-8Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-artPei Liu0Dongxu Jin1Changqing Zhang2Youshui Gao3Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalDepartment of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish a profound strategy for the effective surgical management of these fragile patients. Salvage options are determined according to patient physiological age, functional level, life expectancy, nonunion anatomical site, fracture pattern, remaining bone quality, bone stock, and hip joint competency. In physiologically young patients, care should be taken to preserve the vitality of the femoral head with salvage internal fixation; however, for the elderly population, conversion arthroplasty can result in early weight bearing and ambulation and eliminates the risks of delayed fracture healing. Technical challenges include a difficult surgical exposure, removal of broken implants, deformity correction, critical bone defects, poor bone quality, high perioperative fracture risk, and prolonged immobilization. Overall, the salvage of failed internal fixations of IT fractures with properly selected implants and profound techniques can lead to the formulation of valuable surgical strategies and provide patients with satisfactory clinical outcomes.http://link.springer.com/article/10.1186/s12891-020-03593-8Intertrochanteric femoral fractureHip fractureRevision surgeryFailed fracture fixationSalvage internal fixation |
| spellingShingle | Pei Liu Dongxu Jin Changqing Zhang Youshui Gao Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art BMC Musculoskeletal Disorders Intertrochanteric femoral fracture Hip fracture Revision surgery Failed fracture fixation Salvage internal fixation |
| title | Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art |
| title_full | Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art |
| title_fullStr | Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art |
| title_full_unstemmed | Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art |
| title_short | Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art |
| title_sort | revision surgery due to failed internal fixation of intertrochanteric femoral fracture current state of the art |
| topic | Intertrochanteric femoral fracture Hip fracture Revision surgery Failed fracture fixation Salvage internal fixation |
| url | http://link.springer.com/article/10.1186/s12891-020-03593-8 |
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