Arthroplasty for Fractures
Joint replacement for complex fractures — femoral neck fractures and comminuted proximal humerus fractures — where fixation would carry a prohibitively high risk of failure, non-union, or avascular necrosis.
What is Arthroplasty for Fractures?
While most fractures are treated with fixation, certain fracture types — particularly displaced intracapsular femoral neck fractures in elderly patients and comminuted 3- or 4-part proximal humerus fractures — have unacceptably high rates of fixation failure, non-union, and avascular necrosis when internal fixation is attempted. In these cases, arthroplasty (joint replacement) is the preferred surgical option. For hip fractures: bipolar hemiarthroplasty replaces the femoral head while preserving the native socket — allowing immediate full weight-bearing. For complex proximal humerus fractures in elderly patients: reverse total shoulder arthroplasty provides reliable pain relief and function even when the rotator cuff cannot be reconstructed.
How the Procedure Works
Pre-op Assessment
Fracture pattern, bone quality, patient age, activity level, and comorbidities are assessed — determining whether fixation or arthroplasty is the optimal approach.
Fractured Bone Excision
The comminuted femoral head or proximal humerus is carefully removed along with fracture fragments.
Implant Selection
Bipolar hemiarthroplasty (hip) or reverse total shoulder arthroplasty (shoulder) is selected based on the patient's anatomy and bone quality.
Prosthesis Implantation
The prosthesis is cemented or cementless-press-fit into the prepared canal; stability and range of motion are tested.
Immediate Weight-Bearing
Full weight-bearing begins day one (hip hemiarthroplasty) — the primary advantage over fracture fixation in elderly patients.
Outcomes
Who Needs This Treatment?
- →Immediate full weight-bearing from day one — critical in elderly fracture patients
- →Avoids the high failure risk of fixation in displaced subcapital fractures
- →Bipolar design reduces long-term acetabular wear
- →Reverse shoulder arthroplasty works even with complete rotator cuff loss
- →More predictable outcome than fixation in high-risk fracture patterns
- →Shorter total hospital stay and rehabilitation duration
"For a frail elderly patient with a displaced hip fracture, getting them walking the next day is the difference between a good recovery and a cascade of life-threatening complications. Arthroplasty makes that possible in a way that fixation simply cannot in these high-risk fractures."
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic & Trauma Surgeon, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked
Not sure which treatment is right for you?
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