[Management of unstable pertrochanteric femoral fracture by alloarthroplastic joint replacement]

The treatment of trochanteric fractures of the femur should aim at the reconstruction of the joint function and should allow early weight bearing. In the case of unstable fractures and advanced osteoarthritis of the hip joint the advantages and risks of a total hip replacement have to be compared with different methods of osteosynthesis. We report on 35 patients with trochanteric fractures primarily treated with a total hip replacement. Their perioperative mortality was 9%, the most common complication was a luxation of the replaced hip joint in 3 cases. 1 patient had to be reoperated because of a soft tissue infection. Comparing the literature the primary total hip replacement shows a lower morbidity and mortality rate than complicated methods of osteosynthesis.