Outcome analysis of primary cemented bipolar hemiarthroplasty in elderly unstable intertrochanteric fractures during covid phase in Central India

Authors

  • Arpit Maurya Department of Orthopedics, MGM Medical College and MY Hospital, Indore, Madhya Pradesh, India
  • Ankit Thora Department of Orthopedics, MGM Medical College and MY Hospital, Indore, Madhya Pradesh, India
  • Pranav Mahajan Department of Orthopedics, MGM Medical College and MY Hospital, Indore, Madhya Pradesh, India https://orcid.org/0000-0001-5077-7537

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231989

Keywords:

Bipolar hemiarthroplasty, FIM score, Harris hip score, Intertrochanteric femur fracture

Abstract

Background: The incidence of inter-trochanteric fractures of the femur is very high in the elderly population. The world-wide incidence of all hip fractures is around 402 per 100000 and the incidence of Intertrochanteric fracture is estimated to be around 171 per 100000 in 2019. All the operative conditions were different during covid phase. We needed early ambulation of our patients for a faster recovery and avoid long stay in hospitals.

Methods: 30 patients with unstable intertrochanteric fractures were operated by bipolar hemiarthroplasty during the covid phase. All the patients were followed up at 2, 6, 10 and 16 weeks. Harris hip score and FIM score were assessed.

Results: Mean Harris hip score achieved was 87 at 16 weeks and mean FIM score achieved was 78.9 at 16 weeks indicating good functional outcomes. The outcome was excellent in 23.4%, good in 63.3%, fair in 10% and poor in 3.3% as per HHS.

Conclusions: This procedure offered pain free mobile hip with early mobilization, easy rehabilitation and early return to functional level, when standard techniques were used.

References

Kannus P, Parkkari J, Sievδnen H, Heinonen A, Vuori I, Jδrvinen M. Epidemiology of hip fractures. Bone. 1996;18:57S–63.

Adeyemi A, Delhougne G. Incidence and economic burden of intertrochanteric fracture: a Medicare claims database analysis. JBJS Open Access. 2019;4(1).

Dhanwal DK, Siwach R, Dixit V, Mithal A, Jameson K, Cooper C. Incidence of hip fracture in Rohtak district, North India. Arch Osteopor. 2013;8:1-5.

Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W. Fracture and dislocation classification compendium: Trauma Association classification, database and outcomes committee. J Orthop Trauma. 2007;21:S1-133.

Larsson S. Treatment of osteoporotic fractures. Scand J Surg. 2002:91:140-6.

Bannister GC, Gibson AG, Ackroyd CE, Newman JH. The fixation and prognosis of trochanteric fractures: a randomized prospective controlled trial. Clinical Orthop Relat Res. 1990;254:242-6.

Chinoy MA, Parker M. Fixed nail plates, versus sliding hip systems for the treatment of trochanteric femoral fractures: A meta analysis of 14 studies. Injury. 1999;30:157-63.

Flores LA, Harrington II. Martin H. The stability ofintertrochanteric fractures treated with a sliding screw plate. J Bone Joint Surg Br. 1990:72:37-40.

Sernbo 1, Fredin H. Changing methods of hip fracture osteosynthesis in Sweden: an epidemiological enquiry covering46,900cases. Acta Orthop Scand. 1993;64:173-4.

Larsson S, Friberg S, Hansson LI. Trochanteric fractures: Mobility, complications, and mortality in 607 cases treated with the sliding-screw plate. Clin Orthop Relat Res. 1990;260:232-41.

Bess RJ, Jolly SA. Comparison of compression hip screw and gamma nail for treatment of peri trochanteric fractures. J South Orthop Assoc. 1997;6:173-9.

Kim WY, Han CH, Park J, Kim JY. Failure of inter trochanteric fracture fixation with a dynamic hip screw in relation to preoperative fractures ability and osteoporosis. Intra Op. 2001;25:360-2.

Jensen JS, Tondevold E, Mossing N. Unstable trochanteric fractures treated the sliding screw-plate system: biomechanical study of unstable trochanteric fractures. III, Acta Ortho Scand. 1978;49:392-7.

Halder SC. The Gamma nail for peri trochanteric fractures. J Bone Joint Surg Br. 1992;74:340-4.

Davis TR, Sher JL, Horsman A, Simpson M, Porter BB, Cheketts RG. Intertrochanteric femoral fractures: mechanical failure after internal fixation. J Bone Joint Surg Br. 1990;72:26-31

Thomas AP. Dynamic hip screws that fail. Injury. 1991;22:45-6.

Silverton CD, Jacobs JJ, Rosenberg AG, Kull L, Conley A, Galante JO. Complications of a cable grip system. J Arthroplast. 1996;11:400-4.

Bess RJ, Jolly SA. Comparison of compression hip screw and gamma nail for treatment of peritrochanteric fractures. J South Orthop Assoc. 1997;6:173-9.

Halder SC. The Gamma nail for peritrochanteric fractures. J Bone Joint Surg Br. 1992;74:340-4.

Elmorsy A, Saied M, Allah A, Zaied A, Hafez M. Primary bipolar arthroplasty in unstable intertrochanteric fractures in elderly. Open J Orthoped, 2012, 2, 13-17

Ukaj S, Gjyshinca B, Podvorica V, Ukaj F, Molliqaj G, Boshnjaku A, et al. Primary hemiarthroplasty for treatment of unstable pertrochanteric femoral fractures (AO/OTA Type 31 A2. 3) in elderly osteoporotic patients. SICOT-J. 2017;3.

Lee YK, Park CH, Koo KH. Fixation of trochanteric fragments in cementless bipolar hemiarthroplasty of unstable intertrochanteric fracture: cerclage wiring. Hip Pelvis. 2017;29(4):262-9.

Sancheti KH, Sancheti PK, Shyam AK, Patil S, Dhariwal Q, Joshi R. Primary hemiarthroplasty for unstable osteoporotic intertrochanteric fractures in the elderly: a retrospective case series. Indian J Orthop. 2010;44:428-34.

Kesmezarcar H, Ogut T, Bilgili MG, Gokay S. Treatment of intertrochanteric fractures in elderly patients. Internal fixation or hemiarthroplasty. Acta Orthop Traumatol Tur. 2005;39.

Pho RW, Nather A, Tong Go, Korku CT. Endoprosthetic replacement of unstable comminuted intertrochanteric fracture of femur in elderly. J Trauma. 1981;21:792-7.

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

Thakur A, Lal M. Cemented hemiarthroplasty in elderly osteoporotic unstable trochanteric fractures using fracture window. Malay Orthop J. 2016;10(1):5.

Broos PL, Rommens PM, Deleyn PR, Geens VR, Stappaerts KH. Pertrochanteric fractures in the elderly: are there indications for primary prosthetic replacement? J Orthop Trauma. 1991;5:446-51.

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Published

2023-06-29

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Original Research Articles