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Revista Médica del Uruguay

Print version ISSN 0303-3295On-line version ISSN 1688-0390


CATALURDA, Pedro; DEL CASTILLO, Juan  and  FRANCESCOLI, Luis. Treatment of trochanteric and subtrochanteric fractures associated to ipsilateral coxarthrosis in patients older than 65 years old. Rev. Méd. Urug. [online]. 2021, vol.37, n.4, e401.  Epub Dec 01, 2021. ISSN 0303-3295.


hip fractures and hip joint arthrosis are highly prevalent conditions among older adults. However, according to clinical examination, they are seldom seen together and today there is no general consensus on the best therapy for these associated conditions. The study aims to update existing knowledge on the treatment of trochanteric and subtrochanteric fractures that are associated to ipsilateral coxarthrosis in patients older than 65 years old.


we conducted a systematized search on Pubmed and Ovid including 2,499 articles and selected 12 studies to perform our bibliographic review based on inclusion and exclusion criteria.


most studies analysed are series of retrospective cases. Cases were classified them into three subgroups to analyse results.


the association between proximal femur fractures and ipsilateral coxarthrosis is rather unusual. When seen, trochanteric fractures are the most frequent ones. There are two therapeutic options to treat this condition: treating the fracture and the articulation in the same surgery, by means of an arthroplasty, or treating the fracture first with osteosynthesis and operating afterwards to treat the articulation condition. Arthroplasty reduces the time of postoperative ambulation and thus avoids medical complications in connection with the fracture disease, what results in better functional outcome in the short term. Osteosynthesis requires a shorter surgery and implies smaller blood loss, what makes it less technically demanding as a procedure.

The mortality rate does not depend on the therapy chosen, but on the presence of three or more comorbilities, or the patient being older than 80 years old.

It is important to define what the most appropriate treatment is for these associated conditions, what would contribute to reducing the effects of the fracture on this group of vulnerable patients.


there is no sufficient scientific evidence to state whether one therapy is better than the other one in these patients.

Keywords : Subtrochanteric fractures; Femoral fractures; Coxarthrosis.

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