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Eur J Trauma Emerg Surg · Jun 2014
Primary prosthetic replacement in per- and intertrochanteric fractures.
- M Hoffmann, M Hartel, J M Rueger, and W Lehmann.
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. mi.hoffmann@uke.de.
- Eur J Trauma Emerg Surg. 2014 Jun 1; 40 (3): 273-7.
PurposeHip arthroplasty is rarely indicated in the treatment of per- and intertrochanteric femur fractures. Although the majority of fractures are amenable to closed- or open reduction and internal fixation (CRIF/ORIF), in some patients the complexity of the fracture or other patient-related factors may cause the orthopaedic surgeon to consider arthroplasty as the treatment of choice. Decision-making is challenging, and a reliable score has not yet been established.ResultsReviewing literature, several predictors of inferior outcome after CRIF/ORIF in per- and intertrochanteric fractures such as age, gender, poor bone quality, hip osteoarthritis, operation time and postoperative weight-bearing restrictions have been identified. Based on the literature review, a novel Hamburg Per- and Intertrochanteric Fracture Score (HPIFS) is proposed to support decision-making for per- and intertrochanteric fracture treatment.ConclusionsCRIF/ORIF remain the workhorses in per- and intertrochanteric fracture management. Arthroplasty offers an advantageous treatment option for a well-defined patient and fracture collective. The HPIFS might support the decision-making process.
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