Total hip arthroplasty as a single procedure for subtrochanteric femur fracture with concurrent hip osteoarthritis: A case report

Femoral subtrochanteric (ST) fractures have a bimodal age distribution and often the result of high-energy trauma in young patients and minor trauma in elderly patients. Intramedullary nailing (IMN) has been the mainstay for repair and is favorable over fixed angle plating due to greater stability and decreased complications. Many elderly patients with femoral fractures also suffer from other general bone-related comorbidities such as osteoarthritis (OA). Traditionally, concurrent ST femur fractures and severe hip osteoarthritis have been treated separately, but there is growing evidence supporting the use of total hip arthroplasty (THA) as a viable treatment choice. Here the case of a 71-year-old female with a right femoral ST spiral fracture and advanced hip OA is presented. The patient was treated for her fracture and hip OA simultaneously through a THA with a long stem prosthesis and FiberTape cerclage wires. The patient followed up in good condition and was able to ambulate with the assistance of a walker then transitioned to a cane. It is proposed that patients with ST femur fractures and hip OA would significantly benefit from THA as a single procedure, and its consideration is recommended in future cases with similar presentations.