| Summary: | 【Abstract】Objective: To introduce bipolar
hemiarthroplasty with a two-step osteotomy technique and
observe its clinical result for unstable intertrochanteric frac-tures in senile patients.
Methods: Fifteen consecutive patients with unstable
intertrochanteric fractures aged from 81 to 92 years with a
mean of 85 years were treated in our hospital from August
2006 to October 2011 (Evans type III in 4 cases, Evans type
IV in 11 cases), who received bipolar hemiarthroplasty with
a two-step osteotomy technique performed by a senior or-thopedic surgeon through posterior approach under general
anesthesia. All cases were evaluated by Zuckerman func-tional recovery score (FRS) and operative risk assessment
software 1, based on the patients' physical and laboratory
examinations preoperatively. The duration and blood loss
have been recorded. There were 4 male cases (4 hips) and 11
female cases (11 hips). All prostheses consisted of Link SP II
femoral stem and bipolar femoral head. All patients were
followed up for more than 1 year.
Results: The average preoperative FRS, predictive
value of operative morbidity and mortality were 83.7 (81.7-85.9), 9.3% (7.3%-15.0%) and 3.5% (2.3%-4.2%), respectively.
The average operation time was 50 minutes with a mean
intraoperative blood loss of 310 ml. There were no operative
or anesthetic complications or deaths within 30 days after
operation. Sitting up was permitted 3 to 4 days, and partial
weight bearing was allowed 5 to 7 days after operation. The
average FRS was 79.3 at 30 days and 84.9 at 1 year
postoperatively. Three patients died of unrelated causes
(one due to myocardial infarction and the others due to
cerebral hemorrhage during at least one-year follow-up).
Conclusion: Bipolar hemiarthroplasty with a two-step
osteotomy technique for unstable intertrochanteric fractures
in the senile patients is a good choice for early ambulation
and good hip function.
Key words: Hemiarthroplasty; Hip fractures; Os-teotomy
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