The functional outcome of hemiarthroplasty with cemented modular bipolar prosthesis in comminuted fracture intertrochanteric femur in elderly population
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254216Keywords:
Intertrochanteric femur fracture, Harris score, Intertrochanteric fractures, Modular bipolar prosthesisAbstract
Background: There are several surgical treatment options available for comminuted intertrochanteric fractures but still, many controversies persist, as the postoperative complications increase with increased age. So, it is necessary to evaluate the role of hemiarthroplasty with cemented modular bipolar prosthesis in treating comminuted intertrochanteric fractures in elderly patients. The study aimed to analyse the functional outcomes of hemiarthroplasty with cemented modular bipolar prosthesis in comminuted fracture intertrochanteric femur in 42 elderly patients.
Methods: In this observational prospective study, all patients were taken up for surgery within seven days of their injury. Assessment was done by the modified Harris Hip Score (HHS) during discharge and follow-up visits and results are analysed by paired t test.
Results: There were 26 male and 16 female patients and a 50-50 % side distribution, with mean blood loss of 363.63 ml. Pre-injury ambulation, hypertension distribution analysis, diabetes distribution, hospital stay distribution analysis was done. Complications included superficial infection (14.29%), re-surgery (9.52%), limb length discrepancy seen in none of 76.19%, with a mean duration of surgery 95.86 minutes.
The primary focus was the functional recovery as measured by the HHS. The average HHS improved progressively from 58.24 at discharge to 85.9 at 6 months, reflecting sustained recovery across all follow-up intervals.
Conclusions: Cemented modular bipolar hemiarthroplasty is a highly effective treatment modality for elderly patients with unstable intertrochanteric fractures facilitating excellent functional recovery and minimizes complication rates.
References
Kannus P, Parkkari J, Sievanen H, Heinonen A, Vuori I, Jarvinen M. Epidemology of hip fractures. Bone. 1996;18:57-63.
Koval KJ, Zuckerman JD. Hip fractures are an increasingly public health problem. Clin Orthop Relat Res. 1998;348:2.
Rockwood PR, Horne JG, Cryer C. Hip fractures: A future epidemic. J Orthop Trauma. 1990;4:388-93.
Laros, G. S., Moore, J. F. Complications of fixation in intertrochanteric fractures. Clin Orthop. 1994;101:110.
Jensen, J. Steen, Tondevold, E., Sonne-Holm. Unstable trochanteric fractures. A comparative analysis of four methods of internal fixation. Actaorthop Sand. 1980;51:949962.
Wolfgang GL, Bryant HH, O’Neill JP. Treatment of intertrochanteric fractures of the femur using sliding screw plate fixation. Clin Orthop 1982;163:148–158.
Suriyajakyuthana W. Intertrochanteric fractures of femur: Results of treatment with 95 degrees condylar blade plate. J Med Assoc Thai. 2004;87:1431-8.
Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty two intertrochanteric hip fractures. J Bone Joint Surg Am. 1979;61:216-21.
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;25:360-362.
Stern MB, Anger man A: Comminuted Inter trochanteric fractures treated with a Leinbach prosthesis. Clin Orthop.1987;(218): 755-780.
Green S, Moore T, Prano F. Bipolar prosthetic replacement for the management of unstable Inter trochanteric hip fractures in the elderly. Clin Orthop. 1987;224:169-77.
A C Vahl, P B Dunki Jacobs, P Patka, H J Th M Haarman: Hemiarthroplasty in elderly, debilitated patients with an unstable femoral fracture in the trochanteric region. Acta Orthop Belgica. 1994;60(3):274-9.
Casey Chan K, Gurdev S Gill. Cemented Hemi arthroplasties for Elderly patients with Inter trochanteric hip fractures. Clin Orthop. 2000;371:206-15.
Rodop O, Kiral, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable Inter trochanteric fractures. Int Orthop. 2002;26(4):233-7.
Chris Grimsrud, Raul J. Monzon, Jonathan Richman and Michael D. Ries: Cemented Hip Arthroplasty With a Novel Cerclage Cable Technique for Unstable Intertrochanteric Hip Fractures. J Arthroplasty. 2005;5:337-43.
C Kayali, H Agus, S Ozluk, C Sanli. Treatment for unstable intertrochanteric fractures in elderly patients. J Orthop Surg. 2006;14(3):240-4.
Geiger F. Trochanteric fractures in the elderly: the influence of primary hip arthroplasty on 1-year mortality. Arch Orthop Trauma Surg. 2007;127(10): 959–66.
Sancheti. Primary hemiarthroplasty in elderly unstable osteoporotic intertrochanteric fracture. Indian J orthop 2010;44(4):428-34.
Sidhu AS. Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients. Int Orthopaed. 2010;34:789–92.
Jaswinder Pal Singh Walia, Dheeraj Sansanwal, Sonam Kaur Walia, Sargun Singh, Avinash Chander Gupta. Role of primary bipolar arthroplasty or total hip arthroplasty for the treatment of intertrochanteric fracture femur in elderly. Pb J Orthopaed. 2011;2:76.
Siwach R, Jain H, Singh R. Role of hemiarthroplasty in intertrochanteric fractures in elderly osteoporotic patients: a case series. Eur J Orthop Surg Traumatol. 2012;22:467–72.
Salunkhe. Cemented hemiarthroplasty in elderly osteoporotic proximal femoral fracture. Med J Dr. D.Y. Patil University. 2012;5(1):679.
Kiran Kumar GN, Sanjay meena, Vijaya Kumar, Manjunath S, Vinaya raj MK. Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study. J Clin Diagnos Res. 2013;7(8):102.
Patil A, Ansari M. Role of Cemented Bipolar Hemiarthroplasty for Comminuted Inter-trochanteric Femur Fracture in elderly osteoporotic patients through a modified Transtrochanteric approach- “SION Hospital Modification”. J Dental Med Sci. 2013;9(4):40-7.
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