{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:20:54Z","timestamp":1788823254642,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Failed internal fixation of intertrochanteric fractures (FIF\u2010ITF) is often treated by conversion hip arthroplasty (CHA). This study aimed to evaluate the results and complications of using standard and long femoral stems in this operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, multi\u2010center study enrolled 31 total hip arthroplasty (THA) and 23 hemiarthroplasties (HA) cases (30 women, 24 men; mean age 76\u2009years) after FIF\u2010ITF between 2012 and 2019, divided into two groups: standard stem group (n\u00a0=\u00a020) and long stem group (n\u00a0=\u00a034). The initial internal fixation includes 38 cases of proximal femoral nail anti\u2010rotation (PFNA), eight cases of the dynamic hip screw (DHS), and eight cases of locking proximal femoral plate (LPFP). The indications for CHA included 38 cases of failure of fixation, seven cases of nonunion, and nine cases of avascular necrosis or posttraumatic osteoarthritis. Perioperative data and complications related to fracture and operation were collected, and preoperative and postoperative clinical and radiological data were analyzed. Clinical outcomes were assessed using Harris hip score (HHS) and 36\u2010item Short Form survey (SF\u201036: including physical function (PF) score and body pain (BP) score). Statistical analyses were performed using the chi\u2010square or Fisher's exact test, and the 2\u2010sample <jats:italic>t<\/jats:italic>\u2010test or Wilcoxon rank sum test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At an average of 5.6\u2009years with a minimum of 2\u2009years follow\u2010up. A significant overall surgeon\u2010related complication rate was detected (27.8% [15\/54]), five cases had an intraoperative femur fracture, one case had a late periprosthetic femoral fracture, two cases had a stem penetration, one case had a cement leakage, and two patients had an early postoperative dislocation, one infection and three cases of stem loosening or subsidence. Long stems had an increased risk of complication (13\/34) compared to standard stems (2\/20) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.031). The operation time and blood loss in the long stem group were higher than those in the standard stem group (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002; 0.017). HHS and SF\u201036 significantly improved in both groups from preoperative to the final follow\u2010up and did not present significant differences at the final follow\u2010up (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CHA following FIF\u2010ITF showed a successful mid\u2010term clinical result, long stem arthroplasty should be approached with caution for the risks of higher complication rate, especially intraoperative femoral fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13574","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T08:00:02Z","timestamp":1668672002000},"page":"124-132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Conversion Hip Arthroplasty Using Standard and Long Stems after Failed Internal Fixation of Intertrochanteric Fractures"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8065-7413","authenticated-orcid":false,"given":"Tengbin","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Fujian Medical University Union Hospital  Fuzhou China"},{"name":"Department of Orthopaedic The First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6337-8009","authenticated-orcid":false,"given":"Xinyu","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic The First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-9181","authenticated-orcid":false,"given":"Changyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic The First Affiliated Hospital of Fujian Medical University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6813-0053","authenticated-orcid":false,"given":"Weiming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Fuzhou Second Hospital Affiliated to Xiamen University  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1268-6727","authenticated-orcid":false,"given":"Ruijin","family":"You","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics 910th Hospital of PLA  Quanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9757-7233","authenticated-orcid":false,"given":"Xu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery Mindong Hospital Affiliated to Fujian Medical University  Ningde 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