Hemiarthroplasty Versus Total Hip Arthroplasty for Recurrent Intertrochanteric Fracture: A Case Report

Intertrochanteric fractures in elderly patients present a significant challenge, particularly when prior fixation has failed. Surgical management options include hemiarthroplasty and total hip arthroplasty (THA), with the choice influenced by factors such as patient age, functional status, and bone integrity. Hemiarthroplasty replaces only the femoral head, whereas THA replaces both the femoral head and the acetabulum. As a less invasive option, hemiarthroplasty may be preferred for older, medically frail patients. This case report discusses an 89-year-old man with a history of open reduction and internal fixation (ORIF) for an intertrochanteric fracture who presented with a recurrent fracture and implant failure. Given his advanced age and functional needs, hemiarthroplasty was selected over THA. The procedure was performed using a posterior approach, balancing the benefits of surgical exposure with the risks of dislocation. This case highlights the decision-making process involved in choosing hemiarthroplasty over THA and compares the benefits and limitations of each procedure.