Conversion Total Hip Replacement After Malunited Intertrochanteric Fracture: A Technical Note
Aasis Unnanuntana, MD, and Stuart B. Goodman, MD, PhD
Dr. Unnanuntana is Orthopaedic Surgeon, and Dr. Goodman is Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California.
Malunited intertrochanteric fracture involves anatomical changes such as medialization of the femoral canal and intramedullary remodeling and sclerosis. These changes introduce difficulties that are not ordinarily encountered with routine total hip replacement. Possible intraoperative complications include spiral femoral fracture during hip dislocation and failure to identify the femoral canal. Therefore, recognizing the anatomical changes before and during surgery is crucial. In this article, we describe specific surgical steps and techniques by which these problems may be avoided, thus minimizing potential complications.