This 2005 narrative review by Haidukewych and Berry addresses how to manage patients whose hip fracture fixation has failed — covering decision-making for both femoral neck and intertrochanteric nonunions and the choice between revision fixation and conversion to arthroplasty.
When you see a patient with pain and hardware back-out after hip fracture fixation, use the age-and-bone-quality algorithm: younger patients with Pauwels III nonunions get valgus osteotomy; older patients with poor proximal bone stock get arthroplasty — but budget for a calcar-replacing stem in 65% of intertrochanteric cases and counsel all salvage THA patients about elevated dislocation risk.
This 2005 narrative review by Haidukewych and Berry addresses how to manage patients whose hip fracture fixation has failed — covering decision-making for both femoral neck and intertrochanteric nonunions and the choice between revision fixation and conversion to arthroplasty.
When you see a patient with pain and hardware back-out after hip fracture fixation, use the age-and-bone-quality algorithm: younger patients with Pauwels III nonunions get valgus osteotomy; older patients with poor proximal bone stock get arthroplasty — but budget for a calcar-replacing stem in 65% of intertrochanteric cases and counsel all salvage THA patients about elevated dislocation risk.