Use of cable plate in the total hip arthroplasty for the failed treatment of dated intertrochanteric fracture of the femur：mid-term follow-up results of 12 cases

JIANG Xu; XU Hui

doi:10.3969/j.issn.2095-252X.2016.04.012

Abstract：Objective To evaluate medium-term clinical and radiographic results of the cable plate in the total hip arthroplasty for the failed treatment of intertrochanteric fracture of the femur.Methods From 2005 to 2012, 12 patients ( 12 hips ) with failed treatment of the intertrochanteric fracture of the femur were treated with total hip arthroplasty plus the reconstruction of the greater trochanter with the cable plate. Ten patients ( 10 hips ) were followed up for more than 2 years. The average duration of the follow-up was 42.7 months ( range: 24 - 81 months ). The average age at the arthroplasty was 62.3 years ( range: 41 - 80 years ). Clinical results were evaluated by Harris hip score, while radiographic results were analyzed by postoperative serial X-ray iflms.Results The average Harris hip score increased from preoperative 17.4 points ( range: 6 - 38 points ) to 87.3 points ( range: 75 - 94 points ) at the latest follow-up with statistical signiifcance (P < 0.001 ). Pain in the greater trochanter was seen in 3 hips, and limp in 4 hips at the latest follow-up. Bony union was observed in 9 hips and ifbrous union was observed in 1 hip. No signs of plate dislocation or cable breakage were seen. Postoperative complications included 1 iatrogenic sciatic nerve injury and 1 dislocation. Revision was not needed in 12 cases.Conclusions Clinical and radiographic results of cable plate reconstruction for the greater trochanter in the total hip arthroplasty for the failed treatment of intertrochanteric fracture of the femur are satisfactory. Although it is technically demanding, the rate of bone union is excellent. Meanwhile, we should emphasize the necessity of postoperative muscle exercises for the improvement of gait.