Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study
Introduction: Intertrochanteric fractures in osteoporotic bones which are grossly comminuted are highly unstable and difficult to treat. Conservative treatment with traction and prolonged immobilization lands up with many complications and often fatality. Rate of failure with internal fixation,...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2013-08-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/3228/39-%205486_PF1(M)_E(C)_F(H)_PFA(PR)_PF3_(PUH)_B.pdf |
| _version_ | 1819090664970780672 |
|---|---|
| author | Kiran Kumar GN Sanjay Meena Vijaya Kumar N Manjunath S Vinaya Raj MK |
| author_facet | Kiran Kumar GN Sanjay Meena Vijaya Kumar N Manjunath S Vinaya Raj MK |
| author_sort | Kiran Kumar GN |
| collection | DOAJ |
| description | Introduction: Intertrochanteric fractures in osteoporotic bones
which are grossly comminuted are highly unstable and difficult
to treat. Conservative treatment with traction and prolonged
immobilization lands up with many complications and often
fatality. Rate of failure with internal fixation, with dynamic hip
screws has been found to be high, especially in osteoporotic
bones. Revision osteosynthesis is technically demanding and
it leads to complications. The aim of this study was to assess
the efficacy of cemented hemiarthroplasty in the management
of proximal femoral fractures in elderly patients with severe
osteoporosis.
Material and Methods: Twenty patients (11 males and 9
females- all were 65 years old or above) who underwent
bipolar arthroplasty for unstable intertrochanteric fractures
were prospectively evaluated. Moore’s approach was used in all
patients. Greater Trochanter encirclage was done in 10 (50%)
patients. Harris hip score was used for the clinical evaluation.
The mean follow up period was 9 months.
Results: In our study which was done on 20 cases which had a
mean age 72.4 years, 14 cases were of type 2 fractures, 3 were
of type 3, 2 were of type 1 fractures and 1 was of type 4. The
average Harris hip score was 75. Excellent to fair results were
obtained at follow-up in 18 (90%) cases and in 2 (10%) cases,
the results were poor. Average hospital stay was 13.3 days.
There was one case of a superficial operative site infection
and one case of a deep infection. There was no case with
loosening of the prosthesis, break in the cement or sinking of
the prosthesis.
Conclusion: The treatment of unstable intertrochanteric
fractures in elderly patients with severe osteoporosis differs
from the treatment of patients with other proximal femoral
fractures. These fractures are better treated with cemented
hemi-arthroplasty than with internal fixation. Besides an early
ambulation and less hospital stay, cemented hemi-arthroplasty
provides stable and mobile hips. Weight bearing can be started
earlier than in other methods of treatment, which prevents any
recumbency related complications. |
| first_indexed | 2024-12-21T22:27:26Z |
| format | Article |
| id | doaj.art-cfbb82e75d094ef4a65d966b7f5d9b0d |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-21T22:27:26Z |
| publishDate | 2013-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-cfbb82e75d094ef4a65d966b7f5d9b0d2022-12-21T18:48:11ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2013-08-01781669167110.7860/JCDR/2013/5486.3228Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective StudyKiran Kumar GN0Sanjay Meena1Vijaya Kumar N2Manjunath S3Vinaya Raj MK4Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.Professor and Head of Department, Department of Orthopaedics, Bangalore Medical College and associated Victoria, Bowring & Lady Curzon Hospitals, Bangalore,Karnataka, India.Senior Resident, Department of Orthopaedics, Bangalore Medical College and associated Victoria, Bowring & Lady Curzon Hospitals, Bangalore, Karnataka, India.Senior Resident, Department of Orthopaedics, Bangalore Medical College and associated Victoria, Bowring & Lady Curzon Hospitals, Bangalore, Karnataka, India.Introduction: Intertrochanteric fractures in osteoporotic bones which are grossly comminuted are highly unstable and difficult to treat. Conservative treatment with traction and prolonged immobilization lands up with many complications and often fatality. Rate of failure with internal fixation, with dynamic hip screws has been found to be high, especially in osteoporotic bones. Revision osteosynthesis is technically demanding and it leads to complications. The aim of this study was to assess the efficacy of cemented hemiarthroplasty in the management of proximal femoral fractures in elderly patients with severe osteoporosis. Material and Methods: Twenty patients (11 males and 9 females- all were 65 years old or above) who underwent bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Moore’s approach was used in all patients. Greater Trochanter encirclage was done in 10 (50%) patients. Harris hip score was used for the clinical evaluation. The mean follow up period was 9 months. Results: In our study which was done on 20 cases which had a mean age 72.4 years, 14 cases were of type 2 fractures, 3 were of type 3, 2 were of type 1 fractures and 1 was of type 4. The average Harris hip score was 75. Excellent to fair results were obtained at follow-up in 18 (90%) cases and in 2 (10%) cases, the results were poor. Average hospital stay was 13.3 days. There was one case of a superficial operative site infection and one case of a deep infection. There was no case with loosening of the prosthesis, break in the cement or sinking of the prosthesis. Conclusion: The treatment of unstable intertrochanteric fractures in elderly patients with severe osteoporosis differs from the treatment of patients with other proximal femoral fractures. These fractures are better treated with cemented hemi-arthroplasty than with internal fixation. Besides an early ambulation and less hospital stay, cemented hemi-arthroplasty provides stable and mobile hips. Weight bearing can be started earlier than in other methods of treatment, which prevents any recumbency related complications.https://jcdr.net/articles/PDF/3228/39-%205486_PF1(M)_E(C)_F(H)_PFA(PR)_PF3_(PUH)_B.pdfintertrochanteric fracturehemiarthroplastybipolarcementedhiposteoporosis |
| spellingShingle | Kiran Kumar GN Sanjay Meena Vijaya Kumar N Manjunath S Vinaya Raj MK Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study Journal of Clinical and Diagnostic Research intertrochanteric fracture hemiarthroplasty bipolar cemented hip osteoporosis |
| title | Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study |
| title_full | Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study |
| title_fullStr | Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study |
| title_full_unstemmed | Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study |
| title_short | Bipolar Hemiarthroplasty in Unstable Intertrochanteric Fractures in Elderly: A Prospective Study |
| title_sort | bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly a prospective study |
| topic | intertrochanteric fracture hemiarthroplasty bipolar cemented hip osteoporosis |
| url | https://jcdr.net/articles/PDF/3228/39-%205486_PF1(M)_E(C)_F(H)_PFA(PR)_PF3_(PUH)_B.pdf |
| work_keys_str_mv | AT kirankumargn bipolarhemiarthroplastyinunstableintertrochantericfracturesinelderlyaprospectivestudy AT sanjaymeena bipolarhemiarthroplastyinunstableintertrochantericfracturesinelderlyaprospectivestudy AT vijayakumarn bipolarhemiarthroplastyinunstableintertrochantericfracturesinelderlyaprospectivestudy AT manjunaths bipolarhemiarthroplastyinunstableintertrochantericfracturesinelderlyaprospectivestudy AT vinayarajmk bipolarhemiarthroplastyinunstableintertrochantericfracturesinelderlyaprospectivestudy |