Intertrochanteric fractures of the femur and osteoarthritis of the ipsilateral hip.

We retrospectively reviewed the radiographs of 255 patients with intertrochanteric fractures over a 2 year period. The incidence of osteoarthritis of the hip joint in these patients was 12.16%, which is less than that reported in the general population, and which confirms the protective effect of osteoarthritis against intertrochanteric fractures. Osteoarthritis was mild in 14, moderate in 19, and severe in 4 hips. Seventeen of the 33 patients had died or were too ill to attend a review clinic. The remaining 16 patients (18 hips) were followed up clinically and radiographically 1 to 5.5 years (mean 2.25 years) after internal fixation of the hip fracture. Three patients with severe osteoarthritis, who were waiting for a total hip replacement before the hip fracture occurred became asymptomatic. There was no significant clinical or radiographic progression of mild and moderate hip osteoarthritis in the remaining 13 patients (15 hips). Intertrochanteric fractures appear to have a beneficial "osteotomy-like" effect on hip osteoarthritis in symptomatic patients.