Title: Functional Outcome of Cemented Bipolar Hemiarthroplasty For Unstable Intertrochanteric Femur Fracture in Elderly Osteoporotic Patients

Authors: Dr Aswin Thankachan. V, Dr Jagajeev. JR, Dr Sabarisree M

 DOI: https://dx.doi.org/10.18535/jmscr/v9i6.13

Abstract

Introduction: Hip fractures in elderly are frequent and their number is increasing fast. Intertrochanteric hip fractures account for approximately half of the hip fractures in elderly; out of this more than 50% fractures are unstable.

In osteoporotic elderly patients, primary stabilization with dynamic hip screws has high failure rates due to implant failure, cut-out of head and penetration into hip. Treatment with cemented bipolar hemiarthoplasty in such patients lessen the duration of recumbency, early rehabilitation the patient, decreases the pulmonary post-operative complications and return of these subjects to the pre-injury level of activity more quickly.

Methodology: This is a longitudinal study, in which 24 patients with age>70 years who had unstable intertrochanteric fracture with no major associated injury who came to orthopedics department, Thiruvananthapuram Medical College, were treated with cemented bipolar hemiarthroplasty.

Result: Patients who underwent cemented bipolar hemiarthroplasty, at 2 weeks, 6 weeks, 3 moths had better Harris hip score than who underwent DHS and they were statistically significant (p<0.001). They were more pain free and had greater range of hip movements. They could be mobilized very early compared with the other group and were able to presume their daily activities early than other group. Harris hip score at final follow up at 1 year in both groups were comparable and no significant difference couldn’t be found out statistically.

Conclusion: After analyzing functional results we conclude that this method is well tolerated by aged patients. Early ambulation is possible thus lessening the chance of developing pulmonary complications and bed sores and a resurgery is less frequently required. This also improves their quality of life and the ability to go back to their original functional status much earlier than DHS.

Keywords: Cemented bipolar hemiarthroplasty, DHS, functional; outcome early mobilization.

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Corresponding Author

Dr Jagajeev. JR

Additional Professor, Department of Orthopaedics, Government Medical College, Thiruvananthapuram