DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20190101

Cemented hemi arthroplasty for unstable intertrochanteric fractures in elderly

Y. V. S. Prabhakar, Venkata Sivaram G. V., R. K. L. Jaiswal

Abstract


Background: The incidence of the intertrochanteric fractures is increasing in recent times. It is found that more and more of these fractures are seen in elderly. The treatment of these fractures was historically non surgical. The use of dynamic hip screw and angled blade plate in the surgical management of these fractures is a recent practice. The objective of the study was to analyse the role of cemented hemi-arthroplasty in the treatment of unstable inter trochanteric fractures in elderly.

Methods: This study was conducted between June 2014 to June 2016. Results were analysed prospectively. From a total 94 inter trochanteric fractures admitted during this period 20 patients were chosen who fulfilled our inclusion criteria. All the patients were treated in Malla Reddy Institute of Medical Sciences. Primary cemented hemiarthroplasty was done in the entire patient by a senior faculty member. The results were assessed according to Harris hip score.

Results: There were 13 females and 7 males in our study. The average age was 69.2 years. There was Evan’s type 1-c 11, 1-d 7 and 1-e 2 in numbers all the patients were followed up for a period of 18 months.

Conclusions: In our short study, it is concluded that the primary cemented hemi arthroplasty is a good option in unstable inter trochanteric fractures in elderly.


Keywords


Unstable, Inter trochanteric, Fractures, Elderly

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References


Koval KJ, Zuckerman JD. Hip fractures are an increasingly important public health problem. Clin Orthop. 1998;348.

Bergström U, Jonsson H, Gustafson Y, Pettersson U, Stenlund H, Svensson O. The hip fracture incidence curve is shifting to the right. Acta Orthop. 2009;80(5):520–4.

Bannister GC, Gibson AG, Ackroyd CE, Newman JH. The fixation and prognosis of trochanteric fractures: A randomized prospective controlled trial. Clin Orthop. 1990;254:242–6.

Kubiak EN, Bong M, Park SS, Kummer F, Egol K, Koval KJ. Intramedullary fixation of unstable intertrochanteric hip fractures: one or two lag screws. J Orthop Trauma. 2004;18(1):12–7.

Sancheti KH, Sancheti PK, Shyam AK, Joshi R, Patil K, Jain A. Primary hemiarthroplasty for unstable osteoporotic intertrochanteric fractures in the elderly: A retrospective case series. Indian J Orthop. 2010;44(4):428–34.

White BL, Fisher WD, Laurin CA. Rate of mortality for elderly patients after fracture of the hip in the 1980's. J Bone Joint Surg Am. 1987;69(9):1335-40.

Sernbo I, Johnell O, Gentz CF, Nilsson JA. Unstable intertrochanteric fractures of the hip. Treatment with Ender pins compared with a compression hip-screw. J Bone Joint Surg Am. 1988;70(9):1297-30.

Stern MB, Angerman A. Comminuted intertrochanteric fractures treated with a Leinbach prosthesis. Clin Orthop Relat Res. 1987;(218):75-80.

Kulkarni GS, Limaye R, Kulkarni M, Kulkarni S. Intertrochanteric fractures. Indian J Orthop. 2006;40:16–23.

Tronzo RG. The use of an endoprosthesis for severely comminuted trochanteric fractures. Orthop Clin North Am. 1974;5(4):679-81.

Rosenfeld RT, Schwartz DR, Alter AH. Prosthetic replacements for trochanteric fractures of the femur. J Bone Joint Surg Am. 1973;55:420.

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

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

Rodop O, Kiral A, Kaplan H, Akmaz I. Primary bipolar hemiprosthesis for unstable intertrochanteric fractures. Int Orthop. 2002;26(4):233-7.