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

Hip & Pelvis ◽  
2018 ◽  
Vol 30 (4) ◽  
pp. 241 ◽  
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

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

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.

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 Distal locked versus unlocked intramedullary nailing for stable intertrochanteric fractures, a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yan-Hui Li ◽  
Tiecheng Yu ◽  
Wenjing Shao ◽  
Yanwei Liu ◽  
Dong Zhu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intramedullary Nailing ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Functional Score ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Intraoperative Bleeding ◽  
Distal Locking

Abstract Background: Intramedullary nails have become the main treatment for intertrochanteric fractures. However, a distal locking procedure during nailing gradually raised controversy. In this study, a systematic review and meta-analysis of clinical trials was performed to summarize existing evidence, aiming to determine the safety and efficacy of distal locking or unlocking in the nailing of stable intertrochanteric fractures. Methods: Appropriate articles were identified using the most common public databases, such as PubMed, Embase, the Cochrane Library, and Google Scholar from the inception of each database to April 2019, without restriction of language, publication date, and considering ongoing trials. Eligible studies were represented by randomized controlled trials or retrospective cohort studies, comparing distal locking and unlocking for the treatment of acute stable intertrochanteric fractures in adult patients. Information regarding methodological quality, patient demographics, and clinical outcomes were extracted independently by two reviewers. Subsequently, patients were divided into a locking and unlocking group.Results: This study included 9 articles, comprising a total of 1978 patients with a similar baseline. The results showed that the unlocking group had a shorter operation time, less intraoperative bleeding, lower transfusion rate, and less thigh pain after the treatment of femoral intertrochanteric fracture when compared with the distal locking group. No significant differences were observed in safety-related outcomes, including mortality, infection rate, cutting out, loss of reduction, backing out of lag screws, cephalic screw breakage, nail breakage, and peri-implant fractures between the two groups. In addition, efficacy-related outcomes including nonunion, delayed healing rates, and the Harris functional score were not significantly different between the two groups. Conclusions: Our pooled analysis demonstrated that distal unlocking of stable intertrochanteric fractures can shorten the operation time, reduce intraoperative bleeding, and reduce the blood transfusion rate. The use of locked or unlocked intramedullary nailing does not affect long-term outcomes regarding complications and function.

scholarly journals Distal locked versus unlocked intramedullary nailing for stable intertrochanteric fractures, a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yan-Hui Li ◽  
Tiecheng Yu ◽  
Wenjing Shao ◽  
Yanwei Liu ◽  
Dong Zhu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intramedullary Nailing ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Functional Score ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Intraoperative Bleeding ◽  
Distal Locking

Abstract Background: Intramedullary nails have become the main treatment for intertrochanteric fractures. However, distal locking procedure during nailing gradually raised controversy. A systematic review and meta-analysis of clinical trials was performed to summarize the existing evidence with the aim at determining the safety and efficacy of distal locking or unlocking in the nailing of stable intertrochanteric fractures. Methods: Appropriate articles were identified using the most common public databases such as PubMed, Embase, the Cochrane Library, and Google Scholar from the inception of each database to April 2019, without restriction of language, publication date, and also considering ongoing trials. Eligible studies were represented by randomized controlled trials or retrospective cohort studies comparing distal locking with unlocking for the treatment of acute stable intertrochanteric fractures in adult patients. Information regarding the methodological quality, patient demographics and all clinical outcomes were extracted independently by two reviewers. Patients were then divided into locking and unlocking group. Results: This study included 9 articles, a total of 1978 patients with a similar baseline. The results showed that the unlocking group had shorter operation time, less intraoperative bleeding, lower transfusion rate, and less thigh pain after the treatment of femoral intertrochanteric fracture compared with the distal locking group. No significant difference was found in safety-related outcomes including mortality, infection rate, cutting out, loss of reduction, backing out of lag screws, cephalic screw breakage, nail breakage, and peri-implant fractures between the two groups. Efficacy-related outcomes including nonunion, delayed healing rates, and Harris functional score were also not significantly different between the two groups. Conclusions: Our pooled analysis demonstrated that the distal unlocking of the stable intertrochanteric fractures can shorten the operation time, reduce intraoperative bleeding, and reduce the blood transfusion rate. The use of locked or unlocked intramedullary nailing does not affect long-term outcomes in terms of complications and function.

Hip arthroplasty for failed internal fixation of intertrochanteric fractures: A Systematic Review and Meta-Analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Milad Khair Makram ◽  
Ahmed Salem Eid ◽  
Ahmed Mohamed Sallam
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
English Language ◽  
Meta Analysis ◽  
Salvage Procedure ◽  
Intertrochanteric Fractures ◽  
Technical Problems ◽  
The Impact

Abstract Background hip replacement is a satisfactory salvage procedure for failed fracture treatment despite the increased operative difficulty. Objectives the purpose of this systematic review and meta-analysis was to review and study literature regarding conversion arthroplasty in patients with failed internal fixation of intertrochanteric fractures to evaluate the results, technical problems and complications, as well as the impact of different variable factors and age. associated with hip arthroplasty and to evaluate the functional outcomes and complications.. Materials and Methods A systematic review of 3 databases (PubMed, Cochrane, and Embase) was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were English-language studies that reported complications or functional outcomes after failed fixation of IT fractures with hip arthroplasty in adult subjects (&gt;18 years of age). Results About 2041 articles were found using search keywords as shown in PRISMA flow chart, By filtration and screening of the title and exclusion of unrelated articles, about 109 articles were found, By applications of all inclusion and exclusion criteria, only 8 articles were fit to undergo this meta-analysis. Conclusion So this study showed a significant improvement in functional outcome of hip arthroplasty after failed intertrochanteric fixations despite the relative complication rate of this procedure.

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