ArticleJournal of orthopaedic case reports2025
Four-Time Failed Subtrochanter Femur Fracture Fixation in Elderly: What's Next - A Case Report.
Article in Journal of orthopaedic case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Subtrochanteric fractures are difficult fractures to manage, and a failed fixation in these fractures is a complex and challenging entities. Re-osteosynthesis and prosthesis replacement are two viable options. We present a case of four failed subtrochanter fracture fixations, managed with cementless long stem total hip replacement and augmented plate. Case Report: A 68-year-old lady presented with pain and difficulty in walking for 12 years with four failed surgeries. The initial diagnosis was a subtrochanteric fracture managed with a proximal femur nail. The construct failed and was revised with a proximal femur plate. After a few years, the plate was broken and revised with the proximal femur nail again. Subsequently, the nail also failed after 3 years for which re-osteosynthesis with proximal femur nail was performed. The fixation again failed after 3 years leading to the inability to bear weight on the limb and pain. Cementless long stem total hip replacement with augmented plate along with bone grafting was performed as a one-time solution to the complexities in the management of 4 time-failed subtrochanter femur fractures. At 1 year of follow-up, the patient was walking pain-free and independently without any aid. Conclusion: Failed subtrochanter femur fracture fixation is a complex situation to manage. Re-osteosynthesis is the favored modality of treatment but prosthesis replacement is a feasible option in elderly patients. Total hip replacement provides a single solution to all the intricate problems in the management of failed subtrochanter femur fractures in the elderly.
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