Indications for Hip Arthroplasty in Trochanteric Fractures

Primary Indications for Hip Arthroplasty in Trochanteric Fractures

• Frail patients may benefit from hemiarthroplasty due to shorter operative time and lower dislocation risk 1

Decision Algorithm for Hip Arthroplasty in Trochanteric Fractures

• For stable intertrochanteric fractures, the primary recommendation is Sliding hip screw or cephalomedullary device, according to the American Academy of Orthopaedic Surgeons 2, 3
• For unstable intertrochanteric fractures, the primary recommendation is Cephalomedullary nail, as suggested by the American Academy of Orthopaedic Surgeons and the Annals of the Rheumatic Diseases 2, 3

Type of Arthroplasty Selection

• Hemiarthroplasty is preferred in frail elderly patients due to shorter operative time and lower dislocation risk, as recommended by the Annals of the Rheumatic Diseases 1
• Total hip arthroplasty may be considered in more active, independent elderly patients, with acceptable functional outcomes, according to the Annals of the Rheumatic Diseases 1

Clinical Pearls and Pitfalls

• Cemented femoral stems are strongly recommended in arthroplasty for hip fractures to improve outcomes, as suggested by the American Academy of Orthopaedic Surgeons and Anaesthesia 2, 5