[Primary treatment of unstable pertrochanteric femoral fractures using a head-neck prosthesis in elderly patients].

OBJECTIVE: Evaluation of the treatment of unstable pertrochanteric femoral fractures with a femoral head prosthesis in older patients. DESIGN: Descriptive. SETTING: University Hospital Nijmegen, the Netherlands. METHOD: From January 1988 through December 1992, 15 patients with 15 unstable pertrochanteric femoral fractures were treated with a femoral head prosthesis and additional wiring of the trochanter. The group consisted of 11 women and 4 men with a mean age of 86 years. Two operations were secondary treatments after broken angled-plate fixation. The other 13 were primary treatments. RESULTS: A stable fixation allowing weight-bearing was achieved in all cases. The operations were accompanied by high morbidity and mortality rates: 4 patients died within 3 months after surgery. One dislocation of the prosthesis occurred. Twelve fractures consolidated, pseudarthrosis of the greater trochanter occurred twice. Five patients regained their preoperative walking ability. CONCLUSION: Femoral head prosthesis with additional wiring is an alternative with few mechanical complications in the treatment of unstable pertrochanteric femoral fractures.