scholarly journals Functional analysis of cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly

2017 ◽  
Vol 4 (1) ◽  
pp. 141
Author(s):  
Sivabalan T. ◽  
Thirunarayanan V. ◽  
Senthil Kumar S. ◽  
Ramprasath D. R. ◽  
Basheer Ahmed S.
Keyword(s):  
Functional Outcome ◽  
Intertrochanteric Fracture ◽  
The Elderly ◽  
Fracture Pattern ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Excellent Outcome ◽  
Unstable Intertrochanteric Fracture ◽  
Cemented Bipolar Hemiarthroplasty

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Intertrochanteric fracture is one of the most common fractures among the elderly osteoporotic population</span><span lang="FR">, constituting about 50% of hip fractures. These fractures are managed either by fixation using dynamic hip screw (DHS), proximal femur nail (PFN) or by replacement, based on the stability of fracture pattern, age of the patient, quality of bone and associated co-morbid conditions. Prosthetic replacement which is routinely done for femoral neck fractures requires modification when done for trochanteric fractures to improve stability. This study aims to analyse the short term functional outcome of </span><span lang="EN-IN">cemented bipolar hemiarthroplasty with medial calcar augmentation for unstable intertrochanteric fractures in elderly.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Our study includes 60 patients of age more than 70 years admitted in our institution during June 2012 to September 2016 with unstable intertrochanteric fractures. All patients operated through posterior approach to hip and cemented hemiarthroplasty with medial calcar augmentation with bone graft was done. Patients were followed up for an average of period of 2 years. Functional outcome was evaluated with Harris Hip score</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">28%<strong> </strong>of<strong> </strong>cases had excellent outcome. 43% of cases had good and 23% of cases had fair outcome. 2% of cases ended with poor outcome. The in-hospital mortality rate was 3.3%. The survival rate of the patients in this study at the end of one year is 85%. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Cemented bipolar hemiarthroplasty with medial calcar augumentation can be considered as a good primary option for elderly unstable intertrochanteric fracture patients with osteoporotic bones and associated co-morbidities.</span></p><p class="abstract"> </p><p> </p>

scholarly journals Short term results of modular bipolar hemiarthroplasty for the treatment of neglected trochanteric femur fracture in the elderly

2019 ◽  
Vol 6 (1) ◽  
pp. 53
Author(s):  
Towseef Ahmad Bhat ◽  
Zameer Ali ◽  
Manik Sehgal
Keyword(s):  
Femoral Fractures ◽  
The Elderly ◽  
Clinical Results ◽  
Good Choice ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Postoperative Rehabilitation ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Fractures Of The Femur

<p class="abstract"><strong>Background:</strong> In rural India because of native practitioner culture people tend to neglect orthopaedic injuries and often present late to the hospitals. Bipolar hemiarthroplasty for neglected intertrochanteric fractures of the femur in the elderly yields good clinical results in terms of early postoperative ambulation. This will have a direct effect on the general condition and postoperative rehabilitation.</p><p class="abstract"><strong>Methods:</strong> Sixteen patients with proximal extracapsular femoral fractures presented average 10.4 weeks late from the day of injury, were treated with modular bipolar hemiarthroplasty. There were 11 men and 5 women, with mean age of 72.8 years (range: 65–83 years). Primary cemented bipolar hemiarthroplasty was performed using the Hardinge lateral approach in a lateral decubitus position. Harris hip score was used for the clinical evaluation of the patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Clinically, the Harris hip score at the last follow-up ranged from 92 to 59, with a mean value of 81.7. Postoperative radiographs showed a good position in all patients. 1 patient developed complication during cementing and 1 case came with dislocation. No case of infection, acetabular erosion, periprostheic fracture or implant loosening was reported in this study.</p><p class="abstract"><strong>Conclusions:</strong> Primary cemented bipolar hemiarthroplasty is a good choice in elderly patients with neglected intertrochanteric fractures of the femur.</p>

scholarly journals Radiological and functional outcome of unstable intertrochanteric fractures treated with proximal femoral locking plate

2021 ◽  
Vol 7 (5) ◽  
pp. 968
Author(s):  
Chanchal Kumar Singh ◽  
Juhi Deshpande
Keyword(s):  
Functional Outcome ◽  
Intertrochanteric Fracture ◽  
Locking Plate ◽  
Lateral Wall ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Systemic Complications ◽  
Neck Shaft Angle ◽  
Loss Of Reduction ◽  
Unstable Intertrochanteric Fracture

<p class="abstract"><strong>Background:</strong> Intertrochanteric fracture is a common orthopaedic injury sustained in elderly population because of osteoporosis and trivial fall. Life threatening systemic complications occur mainly due to immobility.</p><p class="abstract"><strong>Methods:</strong> We included 62 patients (40 males and 22 females) of unstable intertrochanteric fracture (AO 31 A2 and A3) attending Department of Orthopaedics. They were all subjected to surgical treatment with proximal femoral locking plate. Patients were followed up at 3rd, 6th and 12th month for outcomes variables i.e.; functional (Harris hip score, Palmer and Parker mobility score) and radiological outcomes (neck shaft angle, loss of reduction, union and implant related complications). Statistical analysis was done using Friedman’s test after calculating the data in terms of mean and median using SPSS 20 software.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean age of our patients was 64 years, 40 were males and 22 females. 50 patients sustained fracture due to trivial fall and 12 due to RTA. 35 out of 62 patients had medical co-morbidites. 26 patients needed open reduction of fracture and 36 were close reduced. 22 of patients had severe comminution (AO A 3 III type). Average blood loss was 254 ml. Mean degree of loss of reduction was 5 degrees in 6th month and 4 degrees in 12th month. Union was achieved in 48 out of 50 patients at 12th month.  Most of the patients achieved fair to good functional outcome scores at 12th month of follow up. We noticed difficulties in fracture reduction as well as complications related to implant.</p><p class="abstract"><strong>Conclusions:</strong> PFLP is an effective implant in comminuted intertrochanteric fractures with broken lateral wall. Complications can be minimised by following principles of locking plate meticulously.</p>

scholarly journals Primary arthroplasty as an option for surgical treatment of unstable intertrochanteric fracture femur in elderly patients: a retrospective study

2019 ◽  
Vol 5 (2) ◽  
pp. 237
Author(s):  
Shashank Kanchan ◽  
Vikash Raj ◽  
Dinesh Agarwal ◽  
Richa .
Keyword(s):  
Retrospective Study ◽  
Elderly Patients ◽  
Functional Outcomes ◽  
Intertrochanteric Fracture ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Complication Rates ◽  
Early Weight Bearing ◽  
Femur Fractures ◽  
Unstable Intertrochanteric Fracture

<p class="abstract"><strong>Background:</strong> An unstable intertrochanteric fracture in osteoporotic elderly patients presents a very challenging problem to the surgeons. This category of patients if kept in bed for long tends to have many complications like deep vein thrombosis, pneumonia, bed sores, etc. Surgeon’s worldwide face difficulty in getting a good anatomical reduction and do not allow early mobility to these patients because of risk of loss of reduction and implant cut out. The purpose of our study is to study the usefulness of arthroplasty in these patients in terms of better functional outcomes and no increase in complication rates.</p><p class="abstract"><strong>Methods:</strong> It was a retrospective study involving 25 patients (17 females, 8 males) with mean age of 76±2.3 years having intertrochanteric femur fractures (AO type A 2.2 and above) with osteoporosis operated upon with bipolar hemiarthroplasty at IQ City Medical College and NM Hospital between January 2015 and January 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the patients were followed up for a period of 1 year. We had a mean operative time of 75 min (range 55-125 min) with an average blood loss of 450 ml. 4 of our patients required postoperative blood transfusion. All patients walked on 2<sup>nd</sup> postoperative day. We had a mean Harris hip score of 82 and mean VAS of 1 at the end of 1 year.</p><p class="abstract"><strong>Conclusions:</strong> Hemiarthroplasty done in cases of unstable intertrochanteric femur fractures in elderly patients with osteoporotic bones allows early weight bearing thus improves the final functional outcomes. Further randomized trials are required before deriving any conclusions.</p>

scholarly journals Cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures

2018 ◽  
Vol 4 (3) ◽  
pp. 519
Author(s):  
Tushar Chaurasia ◽  
Rajat Charan
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fracture ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Displaced Femoral Neck Fractures ◽  
Uncemented Hemiarthroplasty ◽  
Neck Fracture ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Uncemented Group

<p class="abstract"><strong>Background:</strong> This study compared functional outcome and results between cemented and uncemented bipolar hemiarthroplasty in patients older than 60 years with displaced femoral neck fracture.</p><p class="abstract"><strong>Methods:</strong> Total fifty four patients with displaced femoral neck fracture were enrolled in this study. Out of total twenty eight patients underwent uncemented bipolar hemiarthroplasty and remaining twenty six patients underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patient’s pain and functions were evaluated with visual analogue scale and Harris Hip Score<strong> </strong>and then compared to each other.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in cemented group compared to the uncemented group (p&gt;0.05). The mean pain score was significantly less in the cemented group compared to the uncemented group (p=0.001). Hip functional outcome based on HHS was more in the cemented (p=0.001). The intraoperative and postoperative complication rate was higher in the uncemented group (p&lt;0.05).</p><p><strong>Conclusions:</strong> Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complication and improve patient’s function in less time. </p>

scholarly journals UNSTABLE INTERTROCHANTERIC FRACTURE IN ELDERLY TREATED WITH CEMENTED BIPOLAR HEMIARTHROPLASTY AND TROCHANTERIC RECONSTRUCTION

2015 ◽  
Vol 2 (26) ◽  
pp. 3905-3913
Author(s):  
Jagadeesh Kumar Jayapalan ◽  
Parthasarathy Pandian ◽  
Sankaralingam Pandian ◽  
Chakravarthy Rajendiran ◽  
Venkatesh Duraisamy
Keyword(s):  
Intertrochanteric Fracture ◽  
Bipolar Hemiarthroplasty ◽  
Unstable Intertrochanteric Fracture ◽  
Cemented Bipolar Hemiarthroplasty
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