A comparative study on functional outcome of unstable intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw fixation: a short term perspective analysis

Authors

  • M. R. Anand Department of Orthopedics, Government Tiruvarur Medical College. Tiruvarur, Tamil Nadu, India
  • N. S. Ramachandren Department of Orthopedics, Government Tiruvarur Medical College. Tiruvarur, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20200523

Keywords:

Comparative study, Functional outcome, Unstable intertrochanteric fractures, Elderly treated with bipolar hemiarthroplasty, Dynamic hip screw

Abstract

Background: Trochanteric hip fractures in elderly patients have benefited from advances in internal fixation. Early failure of internal fixation occurs however in a number of cases. The failure after internal fixation had been due to initial fracture pattern, communication, sub-optimal fracture fixation and poor bone quality. The aim of this prospective comparative study is to analyze the short term follow up results of unstable Intertrochanteric fractures in elderly treated with bipolar hemiarthroplasty and dynamic hip screw (DHS) fixation.

Methods: This is a study conducted in the Department of Orthopaedics, Government Tiruvarur Medical College, Tiruvarur. 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases).

Results: 42 elderly osteoporotic patients with unstable intertrochanteric fractures who were divided into two groups with group A-bipolar prosthesis (21 cases) and group B-DHS (21 cases). Patients were evaluated clinically using the Harris hip score during their follow up period. In both groups, the most common Singh’s index was grade III, 61.90%in both group A and group B.

Conclusions: From our results, we are of the opinion that bipolar hemiarthroplasty may be an efficient option in elderly osteoporotic intertrochanteric fractures. It reduces the potential complications of prolonged immobilization such as pressure sores, pulmonary complications by early mobilization.

Author Biography

M. R. Anand, Department of Orthopedics, Government Tiruvarur Medical College. Tiruvarur, Tamil Nadu, India

assistant professor , annamalaiuniversity, chidambaram

References

Audio L, Hanson B, Swiontkowski MF. Implant-related complications in the treatment of unstable intertrochanteric fractures: a meta-analysis of dynamic screw plate versus dynamic screw-intramedullary nail devices. Int Orthop. 2003;27:197-203.

Bartucci EJ, Gonzalez MH, Cooperman DR. The effect of adjunctive methylmethacrylate on failures of fixation and function in patients with intertrochanteric fractures and osteoporosis. J Bone Joint Surg Am. 1985;67:1094-107.

Green S, Moore T, Proano F. Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly. Clin Orthop Relat Res. 1987;224:169-77.

Grimmsrud C, Monzon RJ, Richman J, Ries MD; Cementedhiparthroplasty with a novel circle cable technique for unstable intertrochanteric hip fractures; J Arthroplasty. 2005;20(3):337-43.

Haidukewych GJ, Berry DJ. Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures; JBJS (Am). 2003;85(5):899-904.

Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83:643-50.

Harwin SF, Stern RE, Kulick RG; Primary Bateman Leinbach bipolar prosthetic replacement of the hip in the treatment of unstable intertrochanteric fractures in the elderly; Orthopaedics. 1990;13:1131-6.

Hernigou P, Poignard A, Mathieu G, Cohen G, Manicom O, Filippini P. Total hip arthroplasty after the failure of per- and subtrochanteric fracture fixation in elderly subjects. (French). Rev Chir Orthop. 2006;92.

I'm GI, Shin YW, Song YJ. Potentially unstable intertrochanteric fractures. J Orthop Trauma 2005;19:5-9.

Lafosse JM, Molinier F. Cementless modular hip arthroplasty as a salvage operation for failed internal fixation of trochanteric fractures in elderly patients. Acta Orthop Belg. 2007;73:729-36.

Sancheti KH, Sancheti PK. primary hemiarthroplasty for unstable intertrochanteric fractures in elderly - a retrospective case series. Indian J Orthop. 2010;44:89-96.

Kyle RF, Cabanela ME, Russell TA, Swiontkowski MF, Winquist RA, et al. Fractures of the proximal part of the femur. Instr Course Lect. 1995;44:227-53.

Levy RN, Siegel M, Sedlin ED, Siffert RS. Complications of Ender- Pin Fixation in Basicervical, Intertrochanteric, and Subtrochanteric Fractures of the Hip. J Bone Joint Surg. 1983;65:66-9.

Liang YT, Tang PF, Gao YZ, Tao S, Zhang Q, Liang XD, et al. Clinical research of hemiprosthesis arthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients. Zhonghua Yi XueZaZhi. 2005;85(46):3260-2.

Gulati PS, Sharma R. Comparative study of treatment of intertrochanteric fractures of the femur with long-stem bipolar prosthetic replacement versus dynamic hip screw fixation. Pb J Orthop. 2009;9(1):38-40.

Rodopi O, Kiral A, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable intertrochanteric fractures. Int Orthop. 2002;26:233-7.

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Published

2020-02-25

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Original Research Articles