The use of an innovative femur neck prosthesis in case of complications after hip fracture surgery

Abstract

The surgeon can notice severe arthrotic changes of the articulating surfaces of the hip joint during the osteosynthesis procedure. Facing a fracture of the proximal femur the surgeon should as first treat the fracture, then wait until its bony consolidation afterwards he has to decide what to do to cure the arthrotic hip. Normally the implant should be completely removed after a period of 12 months when a solidly fracture healing can be found and a so-called conventional hip prosthesis (cemented or cementless) has to be implanted. All these femoral components are fixed in the intramedullary cavity of the proximal femur. In a lot of cases when the DMS or a similar device is removed a well incorporated plate and a stable connection between the plate and the bone is found. This frequent intraoperative observation led to the idea to leave this bone-implant connection untouched, to remove only the lag screw and place the DMP over it thus resulting a total hip replacement with an extramedullary fixation of the femoral part of the prosthesis.