Functional outcome of intertrochanteric fractures treated with bipolar hemiarthroplasty

Rahul Kadam, Ritesh Sawant, Abhay Chhallani


Background: Comminuted intertrochanteric fractures with severe displacement are common in elderly patients. These patients have poor bone quality and conventional osteosynthetic procedures frequently lead to non-union and metal failure. The primary goals of treatment are stable fixation and early rehabilitation. There are a many treatment for intertrochanteric fractures but our study is on unstable intertrochanteric fractures which are challenging for a surgeon. The aim of this study was to evaluate the results of cemented bipolar hemiarthroplasty as an alternative to other treatment modalities such as DHS or PFN. 21 elderly patients with comminuted and unstable intertrochanteric fractures underwent cemented bipolar hemiarthroplasty.

Methods: This study includes 22 cases of intratrochantric fracture. Mean age of patients was 73.3 (range 60 - 91). All patients are treated with bipolar hemiarthoplasty. Patients are followed up for a mean period of 6 months (range 3-9 months).

Results: These patients were evaluated using the Harris hip scoring system. 21 out of 22 had excellent to fair outcomes.

Conclusions: In our study of 22 patients, 21 had excellent to fair outcomes with primary cemented bipolar hemiarthroplasty. Bipolar hemiarthoplasty offers good functional outcome and early weight bearing and mobilization.


Intertrochanteric fractures, Bipolar hemiarthroplasty, Harris hip scores

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Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83(5):643-50.

Kang SY, Lee EW, Kang KS, Song KS, Lee SH, Park YU, et al. Mode of fixation failures of dynamic hip screw with TSP in the treatment of unstable proximal femur fracture: biomechanical analysis and a report of 3 cases. J Korean Orthop Assoc. 2006;41(1):176-80.

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

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.

Baumgaertner MR, Levy RN. Intertrochanteric hip fracture. In: Browner BD, Levine AM, Jupiter JB, editors. Skeletal Trauma. Volume 2. Philadelphia: W B Saunders; 1992: 1833-1881.

Tronzo RG. The use of an endoprosthesis for severly comminuted trochanteric fractures. Orthop Clin North Am. 1974;5:679-81.

Stern MB, Goldstein TB. The use of the Leinbach prosthesis in intertrochanteric fractures of the hip. Clin Orthop Relat Res. 1977;128:325-31.

Liang YT, Tang PF, Guo YZ, Tao S, Zhang Q, Liang XD, et al. Clinical research of hemiprosthesisarthroplasty for the treatment of unstable intertrochanteric hip fractures in elderly patients. Zhonghua Yi Xue Za Zhi. 2005;85:3260-2.

Grimsrud C, Monzon RJ, Richman J, Ries MD. Cemented hip arthroplasty with a novel cierclage cable technique for unstable intertrochanteric hip fractures. J Arthroplast. 2005;20:337-43.

Kim WY, Han CH, Kim JY. Failure of intertrochanteric fracture fixation with dynamic hip screw in relation to pre-operative fracture stability and osteoporosis. Int Orthop. 2001;25:360-2.

Haq RU, DhammiI K. Clinical outcome following treatment of stable and unstable intertrochanteric fractures with dynamic hip screws. Ann Acad Med Singapore. 2012;41(6):275-6.