Background: Unstable hip fractures in elderly patients a unique
challenge for orthopedic surgeons. Most of the cases are to
be managed by surgical intervention. The problems of old age
include the presence of osteoporosis, pre-existing arthritis, the
overall health of the patient. We in the present study tried to
evaluate the functional outcome of surgical management of
unstable intertrochanteric fractures by various methods and
study the effectiveness and complications of the operative
management of unstable fractures.
Methods: This cross-sectional study was carried out in the
Department of Orthopedics, Prathima Institute of Medical
Sciences, Nagunur, Karimnagar. All patients with unstable
intertrochanteric fractures with age > 65 years who are treated
by the surgical intervention were included in the study. All the
patients were operated in Spinal anesthesia and The standard
surgical procedures were followed for different modalities like
DHS, PFN, Enders Nail’s and cemented bipolar
hemiarthroplasty was done.
Results: Out of n=50 patients n=28(56%) were female and
n=22(44%) were males. The average duration of hospital stay
was 14 days, with a range of 10-25 days. The mean blood loss
in cemented bipolar hemiarthroplasty was 300 ml, PFN 100
ml, DHS was 250ml, and Ender’s Nail was 50ml. In our study of
Bipolar hemiarthroplasty out of n=9 patients n=3 (33.34%) had
excellent, n=5(55.56%) good outcome, n=1(11.12%) had fair
outcomes respectively. Out of n=9 patients of PFN n=4 (44.44
%) of excellent, good n=4(44.44%), fair n=1 (11.12%) patient
and no poor results. Out of n=25 patients of DHS n=20 (80%)
patients are excellent to good results, n=3(12%) patient had
fair and n=2 (8%) patients had poor results. Out of 7 patients
of Ender’s nails n=2(28.573) had excellent and n=3(42.85%)
had good and n=1(14.28%) fair, n=1(14.28) had poor results.
Conclusion: Intertrochanteric Fractures in the geriatric
population are a unique challenge it requires early operative
management which will reduce both mortality and morbidity.
Early mobilization following operative treatment will reduce
the risks associated with prolonged bed rest in geriatric
patients. Since failure rate is still high in unstable
intertrochanteric fractures selection of proper implants is
important for the ultimate success of the treatment.
Cemented bipolar hemiarthroplasty with a novel cerclage cable technique for unstable intertrochanteric hip fractures in senile patients
