Intertrochanteric Fracture in a Long-term Ankylosed Hip: A Case Report

INTRODUCTION: The main objectives in the treatment of an intertrochanteric fracture in elderly population are to prevent medical complications, maintain mobility, independence, and relieve pain. When this fracture occurs in an arthrodesed hip, there is a significant lack of scientific evidence of optimal treatment and clinical results since only few case reports have been published so far. CASE REPORT: A Caucasian 83-year-old woman slipped and fell, complaining of the left hip pain. After radiographic evaluation, she was diagnosed with an intertrochanteric fracture that occurred in a long-term arthrodesed hip. We treated this rare presentation by open reduction and internal fixation with a proximal locking femoral plate and a pelvic reconstruction plate. No immobilization was needed in the post-operative care. Fracture healing occurred after 3months. CONCLUSION: Without motion on the hip, the lower extremity forms one long lever arm, creating an unusual instability at the fracture site. The authors decided that, to overcome this situation, the construction had to be reinforced and extended from the iliac wing to the proximal femur with two plates. This provided enough strength and stability to allow an uneventful fracture healing. This approach can be easily reproduced and can be considered in future similar patients.