全股関節置換術による大腿骨近位部骨折の固定失敗例に対するサルベージ治療：症例シリーズ

Failed fracture fixation around the hip presents a major challenge in orthopedic surgery. Primary total hip arthroplasty (THA) is often required as a definitive salvage procedure following complications such as non-union, malunion, implant failure, or post-traumatic arthritis.

This study aims to evaluate the clinical outcomes, complications, and surgical strategies of primary THA performed as a salvage procedure following failed internal fixation of fractures around the hip, with emphasis on the use of adjuncts such as Prolene mesh, augmentation plates, cerclage wires, and bone grafting.

This case series was conducted at Government Stanley Medical College and Hospital over a period of 2 years. Ten patients with failed hip fracture fixation underwent THA through the lateral Hardinge approach. Pre-operative imaging included radiographs and computed tomography scans. Post-operative assessments were performed using the Harris Hip Score at regular intervals up to 2 years.

All 10 patients experienced excellent to good outcomes in terms of pain relief and functional improvement. Augmentation implants were used in selective cases. Minor complications included two superficial infections and three cases of transient abductor weakness. No readmissions were reported.

Primary THA is an effective salvage strategy following failed hip fracture fixation, with favorable outcomes when thorough pre-operative planning and appropriate surgical techniques are employed. Augmentation devices play a key role in achieving optimal biomechanical restoration in complex cases.