Treatment of pathological fractures of the hip by endoprosthetic replacement.

Overview

In 167 consecutive pathological or impending fractures of the hip treated by endoprosthetic replacement from 1975 to 1978, there was dramatic relief of pain in all patients. Either a long-stem femoral endoprosthesis or a total prosthetic hip was used. The ambulatory status was significantly enhanced in those patients who were able to walk but it was not in the gravely ill. Cementing the prosthesis allowed stabilization of the entire femur as well as resection of diseased bone. The patients had a median survival time of 5.6 months. There were no dislocations, instances of loosening, or failures of the device, and the incidence of deep infection was 1.2 per cent. If the anticipated life of the patient exceeds one month, that constitutes an indication for prosthetic replacement for treatment of a pathological or impending fracture of the hip.