Role of Primary cemented Bipolar hemiarthroplasty for comminuted unstable intertrochanteric fractures in elderly patients

Background: Comminuted intertrochanteric fractures with severe displacement are common in elderly patients. These patients have poor bone quality and conventional osteosynthetic procedures frequently lead to non-union and metal failure. The primary goals of treatment are stable fixation and early rehabilitation. There are a many treatment for intertrochanteric fractures but our study is on unstable intertrochanteric fractures which are challenging for a surgeon. The aim of this study was to evaluate the results of cemented bipolar hemiarthroplasty as an alternative to other treatment modalities such as DHS or PFN. 21 elderly patients with comminuted and unstable intertrochanteric fractures underwent cemented bipolar hemiarthroplasty.Methods: This study includes 22 cases of intratrochantric fracture. Mean age of patients was 73.3 (range 60 - 91). All patients are treated with bipolar hemiarthoplasty. Patients are followed up for a mean period of 6 months (range 3-9 months).Results: These patients were evaluated using the Harris hip scoring system. 21 out of 22 had excellent to fair outcomes. Conclusions: In our study of 22 patients, 21 had excellent to fair outcomes with primary cemented bipolar hemiarthroplasty. Bipolar hemiarthoplasty offers good functional outcome and early weight bearing and mobilization.

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Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

Hip & Pelvis ◽

10.5371/hp.2018.30.4.241 ◽

2018 ◽

Vol 30 (4) ◽

pp. 241 ◽

Cited By ~ 2

Author(s):

Jun-Il Yoo ◽

Yong-Han Cha ◽

Kap-Jung Kim ◽

Ha-Yong Kim ◽

Won-Sik Choy ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Cemented Bipolar Hemiarthroplasty

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A Study on the outcome of surgical management of Unstable Intertrochanteric Fractures in the geriatric population by various modalities

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0801.09 ◽

2020 ◽

Vol 8 (1) ◽

pp. 43-47

Author(s):

Ram Reddy V ◽

Mohd Inayatulla Khan

Keyword(s):

Surgical Management ◽

Surgical Intervention ◽

Operative Management ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Geriatric Population ◽

Cross Sectional ◽

Unique Challenge ◽

Mortality And Morbidity ◽

Cemented Bipolar Hemiarthroplasty

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.

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Primary cemented bipolar hemiarthroplasty by transtrochanteric approach in unstable intertrochanteric fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20212362 ◽

2021 ◽

Author(s):

Thomas Angelo Skariah ◽

Koshy George ◽

Deny Mathew ◽

James C. George ◽

Samuel Chittaranjan

Keyword(s):

Elderly Patients ◽

Successful Treatment ◽

Tertiary Care ◽

Postoperative Outcome ◽

Early Mobilization ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Tertiary Care Centre ◽

Duration Of Surgery ◽

One Year

Background: The successful treatment of unstable intertrochanteric fractures of the femur in elderly patients is a challenge. Due to complications associated with internal fixation, primary hemiarthroplasty is increasingly becoming an alternative treatment to achieve early mobilisation. A transtrochanteric approach could potentially decrease the complications associated with primary hemiarthroplasty. Aim of the study is to document the postoperative outcome and complications associated with this treatment.Methods: In this retrospective study, all elderly patients with unstable trochanteric fractures, treated by primary hemiarthroplasty through a transtrochanteric approach, in a tertiary care centre, from September 2017 to December 2019, were enrolled. Their data from hospital records were analysed and results compared to literature.Results: 48 patients underwent the procedure. Average age was 85 years. One year mortality was 31.25%. Average duration of surgery is 85 min. 58.3% were ambulant at one year. One case of dislocation secondary to surgical site infection was present.Conclusions: Primary hemiarthroplasty as a primary treatment in this group of patients enables early mobilization and prevents complications associated with prolonged immobilization. Transtrochanteric approach reduces the duration of surgery. Achieving early ambulation is the key to successful treatment.

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