Management of Failed Trochanteric Fracture Fixation With Cementless Modular Hip Arthroplasty Using a Distally Fixing Stem

Failure of internal fixation of intertrochanteric fractures is associated with delayed union or malunion resulting in persistent pain and diminished function. We evaluated 15 elderly patients treated with a tapered, fluted, modular, distally fixing cementless stem. At an average follow-up of 2.86 years, mean Harris hip score improved from 35.90 preoperatively to 83.01 (P < .01). Fourteen stems had stable bony ongrowth, and one stem was loose. Distal fixation with a tapered, fluted, modular cementless stem allows stable fixation with good functional outcome in a reproducible fashion in this challenging cohort of patients.