A COMPARATIVE STUDY OF TREATMENT OF UNSTABLE INTERTROCHANTERIC FRACTURES WITH PROXIMAL FEMORAL NAILING AND CEMENTED HEMIARTHROPLASTY IN ELDERLY PATIENTS

Abstract

Introduction: Fractures of the Intertrochanteric region are some of the most common fractures encountered by an orthopaedic surgeon. With increase in life expectancy, the incidence of these fractures is also increasing. The incidence of hip fractures worldwide is estimated at 1.6 million. Hip fractures always cause short term and long-term complications and morbidities. Intertrochanteric fractures in osteoporotic bones with gross comminution are highly unstable and are associated with a high risk of morbidity and mortality. Aim: To compare the clinical outcome in patients operated with proximal femoral nailing versus patients operated with cemented hemiarthroplasty in case of unstable intertrochanteric fractures of elderly patients. Materials And Methods: This is a hospital based comparative study done in elderly patients of age 65 years and above with unstable intertrochanteric fractures being admitted in Apollo Hospitals, Bhubaneswar. Sample size had been determined on the basis of availability of the patients and was taken as 25 for proximal femoral nailing and 25 for cemented hemiarthroplasty on the basis of randomisation sampling method before March 2020 .Patients were evaluated on the basis of clinical history, clinical examination , surgical and post-operative rehabilitation after taking proper consent . Results: Cemented hemiarthroplasty for the unstable intertrochanteric fractures of the femur in elderly has good early clinical outcome on the basis of this study . In this study 6thmonth and 9thmonth harris hip score were signicantly more in cemented hemiarthroplasty compared to proximal femur nailing which was statistically signicant. Cemented hemiarthroplasty in unstable intertrochanteric fractures has a major advantage of allowing early mobilization, immediate weight bearing with walker, rapid rehabilitation, shorter hospital stay and early return to work so we believe that cemented bipolar hemiarthroplasty is of choice in freely mobile elderly patients above sixty ve years of age with an intertrochanteric femoral fracture. Conclusion: cemented bipolar hemiarthroplasty is of choice in freely mobile elderly patients above sixty ve years of age with an intertrochanteric femoral fracture.