Thompson hemiarthroplasty through a trochanteric osteotomy approach

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Radiology

Background:

• Displaced subcapital hip fractures are common, particularly in older adults.
• Surgical intervention is often necessary to restore mobility and reduce pain.
• The Thompson prosthesis is a widely used option for hip fracture fixation.

Purpose of the Study:

• To evaluate the clinical outcomes and complications associated with cemented Thompson prosthesis for displaced subcapital fractures.
• To assess the efficacy of a lateral hip approach combined with trochanteric osteotomy in this patient cohort.

Main Methods:

• Retrospective review of 100 patient case histories and radiographs.
• Patients treated with cemented Thompson prosthesis for displaced subcapital fracture.
• Surgical approach: lateral hip joint approach with trochanteric osteotomy.

Main Results:

• Twenty patients (20%) experienced unsound trochanteric reattachment, but only six (6%) were symptomatic.
• No cases of proximal femoral fracture or perforation were reported.
• One instance of hip dislocation (1%) occurred.
• Infection and para-articular ossification rates were comparable to other series.

Conclusions:

• Cemented Thompson prosthesis with a lateral approach and trochanteric osteotomy is a viable treatment for displaced subcapital fractures.
• While trochanteric reattachment issues can occur, they are often asymptomatic.
• The procedure demonstrates a low rate of major complications such as fracture, perforation, and dislocation.