To investigate the therapeutic effect of long-handled femoral head replacement in the treatment of elderly osteoporotic femoral intertrochanteric fractures after the failure of internal fixation, and summarize the clinical experience of this treatment method.

From January 2013 to December 2017, in Xinhui People's Hospital, 18 patients who failed in the internal fixation of the femoral intertrochanteric fractures were treated with long-stem artificial femoral head replacement surgery. Inclusion criteria: age≥70 years, intertrochanteric fracture of trauma with failed internal fixation confirmed by radiography. Exclusion criteria: contraindications of surgery, pathological fractures, Alzheimer's disease or communication difficulties. Harris score was used to evaluate the recovery of hip joint function. The preoperative and postoperative scores were compared by t test.The femoral stem loosening, femoral stem fracture, and hip dislocation were also observed and recorded during the follow-up.

The patients were followed up for (16±4) months in average. the pain was disappeared or was significantly relieved, and the function was improved that the patients could walk under assistance. Compared to the preoperative scores, the difference was statistically significant in postoperative Harris score(83±3) (t =40.563, P <0.05).

Long-stem artificial femoral head replacement is an effective therapy for the patients with osteoporosis intertrochanteric fracture after the failure of internal fixation, which shows satisfactory effect, less rest time in bed, better functional recovery and improvement of the quality of life.