Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis
Background: Hip fractures are common, especially in the elderly population, and orthopedic surgeons frequently face many technical difficulties in their surgical management. It is commonly known that proximal femur fractures can result in failed osteosynthesis, which can be characterized by non-uni...
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| Language: | English |
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ziauddin University
2025-04-01
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| Series: | Pakistan Journal of Medicine and Dentistry |
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| Online Access: | https://ojs.zu.edu.pk/pjmd/article/view/3093 |
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| author | Shahzaib Riaz Baloch Mohammad Sohail Rafi Syed Ata Ur Rahman Imtiaz Ahmed Hashmi Eamaan Abid Faryal Karim |
| author_facet | Shahzaib Riaz Baloch Mohammad Sohail Rafi Syed Ata Ur Rahman Imtiaz Ahmed Hashmi Eamaan Abid Faryal Karim |
| author_sort | Shahzaib Riaz Baloch |
| collection | DOAJ |
| description |
Background: Hip fractures are common, especially in the elderly population, and orthopedic surgeons frequently face many technical difficulties in their surgical management. It is commonly known that proximal femur fractures can result in failed osteosynthesis, which can be characterized by non-union, loss of reduction, or implant loosening. If osteosynthesis is unsuccessful for any reason, the next step in management is likely a complex hip replacement procedure. We hope to advance the current knowledge base and assist in the management of this difficult patient population.
Methods: This retrospective study included 64 patients who underwent complex hip arthroplasty after failed osteosynthesis for proximal femur fractures initially treated with Open Reduction and Internal Fixation (ORIF) from January 2017 to December 2021 using the non-probability Convenience Sampling technique was used. I. Data from Dr. Ziauddin Hospital's electronic records were analyzed for functional and radiographic outcomes up to one-year post-surgery. The Fisher exact test was used for contingency tables, and data was calculated via SPSS version 23, P < 0.05 was considered significant.
Results: Of the 64 patients, 24 were male (37.5%) and 40 females (62.5%). Initial fractures included 26 subtrochanteric (40.6%) and 38 intertrochanteric (59.4%), treated with Proximal Femoral Nail (37.5%), Recon Nail (12.5%), or Dynamic Hip Screw (50%). Failure reasons were cut-outs (59.3%) and non-unions (40.6%). Pre-operatively, most patients had poor or fair Harris Hip Scores (HHS). Post-revision, 62 patients (96.8%) underwent cementless THA, and 2 (3.2%) cemented THA, with significant HHS improvement: 78% scored good, 18.8% excellent, and 3.2% fair.
Conclusion: This study confirmed the efficacy of complex hip arthroplasty for failed osteosynthesis with good radio-clinical outcomes.
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| format | Article |
| id | doaj-art-e67cec92fe5d42cf800d3dfb64cefb82 |
| institution | OA Journals |
| issn | 2313-7371 2308-2593 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | ziauddin University |
| record_format | Article |
| series | Pakistan Journal of Medicine and Dentistry |
| spelling | doaj-art-e67cec92fe5d42cf800d3dfb64cefb822025-08-20T02:26:59Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-04-0114210.36283/ziun-pjmd14-2/054Complex Hip Arthroplasty Following Failed Proximal Femur OsteosynthesisShahzaib Riaz Baloch0https://orcid.org/0009-0003-1741-228XMohammad Sohail Rafi1https://orcid.org/0009-0005-7248-6841Syed Ata Ur Rahman2https://orcid.org/0009-0007-1696-4217Imtiaz Ahmed Hashmi3https://orcid.org/0009-0009-2418-4768Eamaan Abid4https://orcid.org/0009-0002-4608-6009Faryal Karim5https://orcid.org/0009-0003-9024-3216School of Clinical Medicine, The University of Hong Kong, Hong Kong,and Ziauddin Universirty,Karachi,Pakistan.Ziauddin University, Karachi, Pakistan.Ziauddin University, Karachi, Pakistan.Kings College Hospital Dubai, UAEZiauddin University, Karachi, Pakistan.Sheikh Kalifa Bin Zayed Al-Nahyan, Medical Complex, Quetta, Pakistan Background: Hip fractures are common, especially in the elderly population, and orthopedic surgeons frequently face many technical difficulties in their surgical management. It is commonly known that proximal femur fractures can result in failed osteosynthesis, which can be characterized by non-union, loss of reduction, or implant loosening. If osteosynthesis is unsuccessful for any reason, the next step in management is likely a complex hip replacement procedure. We hope to advance the current knowledge base and assist in the management of this difficult patient population. Methods: This retrospective study included 64 patients who underwent complex hip arthroplasty after failed osteosynthesis for proximal femur fractures initially treated with Open Reduction and Internal Fixation (ORIF) from January 2017 to December 2021 using the non-probability Convenience Sampling technique was used. I. Data from Dr. Ziauddin Hospital's electronic records were analyzed for functional and radiographic outcomes up to one-year post-surgery. The Fisher exact test was used for contingency tables, and data was calculated via SPSS version 23, P < 0.05 was considered significant. Results: Of the 64 patients, 24 were male (37.5%) and 40 females (62.5%). Initial fractures included 26 subtrochanteric (40.6%) and 38 intertrochanteric (59.4%), treated with Proximal Femoral Nail (37.5%), Recon Nail (12.5%), or Dynamic Hip Screw (50%). Failure reasons were cut-outs (59.3%) and non-unions (40.6%). Pre-operatively, most patients had poor or fair Harris Hip Scores (HHS). Post-revision, 62 patients (96.8%) underwent cementless THA, and 2 (3.2%) cemented THA, with significant HHS improvement: 78% scored good, 18.8% excellent, and 3.2% fair. Conclusion: This study confirmed the efficacy of complex hip arthroplasty for failed osteosynthesis with good radio-clinical outcomes. https://ojs.zu.edu.pk/pjmd/article/view/3093fractureTHR Failure Revision SurgeryHarris hip score |
| spellingShingle | Shahzaib Riaz Baloch Mohammad Sohail Rafi Syed Ata Ur Rahman Imtiaz Ahmed Hashmi Eamaan Abid Faryal Karim Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis Pakistan Journal of Medicine and Dentistry fracture THR Failure Revision Surgery Harris hip score |
| title | Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis |
| title_full | Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis |
| title_fullStr | Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis |
| title_full_unstemmed | Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis |
| title_short | Complex Hip Arthroplasty Following Failed Proximal Femur Osteosynthesis |
| title_sort | complex hip arthroplasty following failed proximal femur osteosynthesis |
| topic | fracture THR Failure Revision Surgery Harris hip score |
| url | https://ojs.zu.edu.pk/pjmd/article/view/3093 |
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