Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 24047
THE S-ROM STEM IN THE MANGEMENT OF MULTIPLY OPERATED NON
UNIONS OF SUB TROCHANTERIC FRACTURES - A PROSPECTIVE STUDY
Buddhadeb CHATTERJEE
Apollo Gleneagles Hospital, Kolkata (INDIA)
Sub-trochanteric fractures have a high rate of non-union and implant failure which is
attributed to stress concentration and devitalisation of fracture fragments during
surgery.It is genreally agreed that failed screw-plate fixations should be treated with
intramedullary fixation and bone grafting (Haidu kewych and Berry).This prospective
study was performed on 12 patients who had unsuccessful side plate as well as
intramedullary fixation with implant breakage. Instead of a third fixation surgery, they
were subjected to Total Hip Replacement using a modular long non-cemented stem.
The mean age of the patients was 46.8 years with a female preponderance. The
average duration of the non-union was 1.4 years after sustaining the fracture.The S-
ROM stem was selected to have a hold on the proximal fragment with an apatite
coated sleeve and the distal fragment with a fluted pronged stem. The neck length,
offset and versions modularity helped in restoring soft tissue balance and Hip
stability. Post operatively, the patients were allowed guarded weight bearing and
exercises. All patients were able to walk with support on the second post operative
day and without walking aids after 3 months. Pain was absent in 10 patients and 2
needed occasional analgesics. The fracture united in 10 cases. Total Hip
replacement with a modular S-ROM stem is a staisfactory method of treatment in
patients with non united subtrochanteric fractures with repeated failed surgeries and
implant breakage.
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