Functional outcome of unstable intertrochanteric femur fracture in elderly osteoporotic patients treated by primary cemented bipolar hemiarthroplasty versus internal fixation with proximal femoral nailing
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 4
Abstract
Backround: Intertrochanteric fractures in the elderly pose certain special problems and need to be addressed in a balanced way as on one hand senile osteoporosis requires prolonged immobilization, on the other hand rapid mobilization is required as they are generally medically compromised due to age and associated diseases. Despite several randomized trials and comparative studies treatment of unstable intertrochanteric fractures in elderly patients is still controversial, which we want to investigate in this set-up which caters to a vast rural population. Methods: A retrospective analysis of 54 patients, of which 27 each were operated with cemented bipolar hemiarthroplasty (BPA) and proximal femur nail (PFN) between January 2012 till July 2016 was done. Primary outcome was assessed in both groups using Harris hip score( HHS) at 4weeks, 6 weeks, 12weeks, 6months and 1 year on outpatient basis. The secondary outcome measures were intraoperative blood loss, transfusion rate, surgical time, bed to chair time, chair to walking time, limb length discrepancy at final follow up. All complications were noted at follow ups. Results: The HHS was significantly higher for BPA group at all follow ups, at 4 weeks of follow up was 77.81 for BPA and 71.18 for PFN (p-value = 0.001) and at 1 year of follow up was 85.55 for BPA and 77.03 for PFN (p-value = 0.001). Statistically significant differences were found between BPA and PFN groups with reference to intraoperative blood loss, transfusion rate, surgical time, bed to chair time, chair to walking time, limb length discrepancy at final follow up. Conclusion: The bipolar hemiarthroplasty group had fewer complications and earlier mobilization with better Harris hip score at all follow ups, which indicate bipolar hemiarthroplasty is a better option in the treatment of unstable intertrochanteric fractures in senile osteoporotic patients.
Authors and Affiliations
Dr. Hari Prasad S, Dr. Siddaram N Patil, Dr. Sarath Chandra P, Dr. Cecil Fernando A
Keywords
Related Articles
- EP ID EP481537
- DOI 10.22271/ortho.2017.v3.i4e.43
- Views 104
- Downloads 0
Pedicle screw fixation in the lower cervical spine: Case series
Background: Pedicle screw fixation of lower cervical spine is a new technique that provides an alternative to posterior lateral mass plating. Although biomechanical studies suggest the use of pedicle screws to reconstruc...
The role of core decompression in the management of early osteonecrosis of the femoral head
Background: Osteonecrosis represents the death of cellular elements in the marrow which progresses in stages resulting in collapse of the femoral head and its treatment is stage specific. The aim of this study was to eva...
A retrospective analysis of extra articular glenoid neck fracture of scapula (A study of 20 cases)
Introduction: Since long ago the scapula fracture is treated conservatively and most of time it works because scapula is a flat bone and coated with bulky muscle. So, nonunion of the fracture is usually not a problem, an...
Distal tibial osteosarcoma: A technique of custom mega prostheses reconstruction
Primary malignant bone tumours of the distal tibia are very rare. Amputation was the standard surgical treatment with satisfactory functional results obtained using an appropriate prosthesis [1]. But in the era of limb s...
Study of the principles of ponseti technique in the management of idiopathic congenital talipes equinovarus
Clubfoot is one of the commonest congenital conditions seen in orthopaedic practice. Though congenital talipes equinovarus (CTEV) exists from time immemorial, its etiology is unknown, pathology is complex and management...