Functional outcome of primary hemiarthroplasty using bipolar prosthesis for unstable comminuted intertrochanteric fractures of hip in elderly

DR. JACOB MATHEW; DR. JEEJESHKUMAR T. K.; DR. ANEEN N. KUTTY; DR. ANEESH KUMAR K. V.

Volume : VII, Issue : IV, April - 2017

Functional outcome of primary hemiarthroplasty using bipolar prosthesis for unstable comminuted intertrochanteric fractures of hip in elderly

Dr. Jacob Mathew, Dr. Jeejeshkumar T. K. , Dr. Aneen N. Kutty, Dr. Aneesh Kumar K. V.

Abstract :

INTRODUCTION: Intertrochanteric fractures with severe comminution and displacement are common in elderly patients, and these are highly unstable and difficult to treat. These patients have a poor bone quality and the fractures are usually associated with complications such as non–union, implant failure. The primary treatment goal is stable fixation and an immediate full–weight–beå mobilization. To allow an early post–operative weight–beå and rehabilitation and to avoid excessive collapse at the fracture site, some surgeons have recommended prosthetic replacements in elderly patients.

AIM : To assess the Functional outcome of primary hemiarthroplasty using bipolar prosthesis for unstable comminuted intertrochanteric fractures of hip in elderly.

MATERIALS AND METHODS: 20 elderly patients above 70 years who underwent bipolar hemiarthroplasties for unstable comminuted intertrochanteric fractures in Department of Orthopaedics, Govt. Medical College, Kozhikode, were followed and studied.

RESULTS : A majority of the patients had a pain free mobile hip with a full range of flexion, abduction and adequate amount of rotations and adduction. In this study, there was no incidence of loosening of the prosthesis or an acetabular erosion radiologically on follow up. In this study, the final functional results were fair to good according to the Harris hip scoring system, with a mean score of 77.6%.

Conclusion : In elderly patients with severe osteoporosis unstable comminuted intertrochanteric fractures of hip, cemented hemiarthroplasty using bipolar prosthesis is an alternative treatment option with less complication rate, hospital stay, early post–operative mobilization and increased functional outcome.