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Primary prosthetic replacement in per- and intertrochanteric fractures

  • Review Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Hip 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.

Results

Reviewing 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.

Conclusions

CRIF/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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Conflict of interest

M. Hoffmann, M. Hartel, J. M. Rueger and W. Lehmann declare that they have no conflict of interest.

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The manuscript does not contain clinical studies performed by any of the authors or patient data.

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Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    M. Hoffmann, M. Hartel, J. M. Rueger & W. Lehmann

Authors
  1. M. Hoffmann
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  2. M. Hartel
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  3. J. M. Rueger
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  4. W. Lehmann
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Correspondence to M. Hoffmann.

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Hoffmann, M., Hartel, M., Rueger, J.M. et al. Primary prosthetic replacement in per- and intertrochanteric fractures. Eur J Trauma Emerg Surg 40, 273–277 (2014). https://doi.org/10.1007/s00068-014-0412-9

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  • DOI: https://doi.org/10.1007/s00068-014-0412-9

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