Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Hip
Abstract number: 23188
INTERNAL FIXATION OF HIP FRACTURES “CAUSES OF FAILURE AND
OUTCOME OF SALVAGE ARTHROPLASTY
Uthmann ALAO 1 , Michael LEONARD 1 , Aaron GLYNN 1 , Mark DOLAN 2
1 Cork University Hospital, Cork (IRELAND), 2 Cork Uinversity Hospital, Cork
(IRELAND)
Introduction - Failed fixation of hip fractures typically leads to profound functional
disability and pain for the individual, technical challenges for the surgeon, and an
increase in the financial burden. This study had three purposes: (1) to determine the
reason/s for failure of internal fixation (2) to record difficulties / complications
encountered with salvage arthroplasty and (3) to compare the outcome of salvage
arthroplasty with primary hip arthroplasty.Methods Between 1999 and 2005 41
patients were treated at our institution with a total hip arthroplasty for failed fixation of
a hip fracture. We reviewed the charts and radiographs of all patients. We also
compared the outcome of patients who underwent salvage arthroplasty (Group 1)
with a matched group of patients who had a primary hip arthroplasty for degenerative
disease (Group 2).Results - Failure to achieve a good reduction and optimal screw
placement was evident in 80% of cases. A high incidence of complications was
recorded following salvage arthroplasty. Functional outcome was statistically inferior
in group1, this group also had a higher incidence of complications. Radiographs at 2
years post operatively showed evidence of femoral stem loosening in 16% of group1
compared with 3% in group2. Conclusions - When stabilising hip fractures one
should make every effort to achieve optimal reduction and fixation. Salvage
arthroplasty is associated with higher complication rate and poorer outcome than
primary arthroplasty. We recorded a high incidence of femoral stem loosening
following salvage arthroplasty and recommend more frequent follow up of these
patients.
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