Replacement of femoral head endoprosthesis with total hip prosthesis. A report of five cases with problems of management.

Five cases who had endoprosthesis implanted for medial fracture of the neck of the femur are reported. All of them developed late complications that required replacements of endoprosthesis with total hip prosthesis. Complications included wearing of both joint cartilage and subchondral bone of the acetabulum, osteoporosis of the proximal end of the femur and fracture of the femur and the level of the endoprosthesis. Several problems of surgical management ensued. This experience strengthens the author's opinion that other forms of treatment--reduction in traction and nailing or total hip prosthesis--should be tried first also in particular cases of chronologically aged, but physically healthy patients with medial fractures of the neck of the femur.