The role of total hip replacement in intertrochanteric fractures of the femur.

Total hip replacement is rarely used in the treatment of acute intertrochanteric fractures of the femur. Pathologic fractures with involvement of the femoral head and/or periacetabular pelvis may represent one such indication; rheumatoid arthritis with or without radiographic involvement of the joint space or end-stage osteoarthritis with substantial hip symptoms before fracture may represent other indications. Total hip replacement is mainly reserved for the treatment of complications such as nonunion or avascular necrosis of the femoral head.