Functional Outcome Of Primary Cemented Bipolar Hemiarthro-Plasty In Unstable Intertro-Chanteric Fractures Of Elderly – A Prospective Study
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 2
Abstract
Background: Unstable intertrochanteric fractures in elderly are difficult to treat. Internal fixation of these fractures often results in implant failure owing to poor bone quality and complex fragment geometry, necessitating prolonged bed rest post-operatively and thereby increasing the chances of deep vein thrombosis, pulmonary embolism and decubitus ulcer. The purpose of this prospective study is to evaluate the functional outcome of cemented bipolar hemiarthroplasty as a primary treatment for unstable intertrochanteric fractures in elderly patients. Materials and methods: 15 cases of unstable intertrochanteric fractures treated by primary cemented bipolar hemiarthroplasty between September 2013 and June 2015 were included in this prospective study. There were 7 males and 8 females with a mean age of 70.8 years (range 65-95 years). Results: The average follow-up was 11.2 months (range 3-18 months). Two patients were lost to follow-up. 66.7% of the cases admitted were due to trivial trauma and the rest 33.3% due to road traffic accident. Boyd and Griffin Type II fractures accounted for 93.3% of cases. The average blood loss was 300 ml (range 150-550 ml). Mean duration of hospital stay was 14.4 days and mean time to full weight bearing was 4.1 days. There were 2 cases of superficial infection and 1 case of deep infection. 3 patients had shortening of limb post-operatively with an average shortening of 1.6 cm (range 1-2.5 cm). 3 patients were graded as excellent and 10 patients as good at the end of 1 year with a mean Harris Hip Score of 88.9 (range 88-92). Conclusion: Primary cemented bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly reduces the complications of prolonged immobilization, prolonged rehabilitation, marked residual deformities and need for revision surgeries. The procedure offers faster mobilization, rapid return to pre-injury level, thereby improving the quality of life.
Authors and Affiliations
Pragash M, Elango M, Manikandan K
Keywords
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