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Chapter-16 Total Hip Arthroplasty for Neglected Hip Trauma

BOOK TITLE: Neglected Musculoskeletal Injuries

Author
1. Malhotra Rajesh
2. Bhan Surya
ISBN
9788184488890
DOI
10.5005/jp/books/11171_16
Edition
1/e
Publishing Year
2011
Pages
16
Author Affiliations
1. All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences, New Delhi-29, India, All India Institute of Medical Sciences (AIIMS), New Delhi, India, JPN Apex Trauma Center, AIIMS, New Delhi, India
2. Primus Ortho and Spine Hospital, Chanakyapuri, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India, Primus Hospital, Chanakya Puri, New Delhi, India; All India Institute of Medical Sciences, New Delhi, India, All India Institute of Medical Sciences, Ansari Nagar, New Delihi, Primus Ortho and Spine Hospital, Chandragupt Marg, Chanakyapuri, New Delhi, India, All India Institute of Medical Sciences (AIIMS), New Delhi, India, Primus Superspecialty Hospital, New Delhi, India
Chapter keywords

Abstract

Neglected hip trauma is the bane of developing countries. Hip being a major weight bearing joint of the body must be reconstructed to make the patient ambulatory without pain and limp. In most cases, the outcome could have definitely been improved by timely surgical intervention with decreased morbidity and mortality. Late presentations make these injuries more common to complications like avascular necrosis and post traumatic arthritis. The arthroplasty is ideally suited for elderly, low demand patients especially in the presence of preexistent arthritis or avascular necrosis. It provides almost universal pain relief and improved range motion and function with a relatively short period of rehabilitation. The total hip arthroplasty in patients with neglected hip trauma may be complicated by severe disruption of the normal bony architecture with or without severe bony defects requiring grafting, release of soft tissue contractures and correction of preoperative limb length discrepancy. The major concern lies in the durability of the fixation of the component. The review considers total hip arthroplasty (THA) for common neglected hip injuries like femoral neck fractures, trochanteric fractures, hip dislocations and acetabular fractures. Various injuries are described including surgical options available, general guidelines for decision making, choice of implant, technical tips and result of THA in these injuries.

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