Conversion hip arthroplasty for failed nailing of intertrochanteric fracture: Reflections on some important aspects

Table 1 Factors affecting the outcome of surgical fixation of an intertrochanteric fracture

Factors	Specific content
Patient-related factors	Age, sex, comorbidities, fracture pattern and comminution, intactness of lateral wall, bone quality, osteoporosis
Surgery-related factors	Reduction quality of the fracture, placement and selection of fixation devices, tip-apex distance
Postoperative management	Protective hip joint functional rehabilitation and anti-osteoporosis treatment

Table 2 Advantages and disadvantages of nailing fixation vs primary arthroplasty for an intertrochanteric fracture

	Operative time	Blood loss	Postoperative bedridden time	Re-operative rate	Long-term effect	Applicability preference
Nailing fixation	Shorter	Less	Longer	Comparable	Comparable or superior	Younger patients with lower-grade fracture pattern, good bone quality, fewer comorbidities, higher functional demands, and longer life expectancy
Primary arthroplasty	Longer	More	Shorter	Comparable	Comparable	Elderly patients with higher-grade fracture pattern, poor bone quality, more comorbidities, lower functional demands, and shorter life expectancy