Functional outcome of hemiarthoplasty as a treatment option for trochanteric fractures

Abstract

Objectives: Management of unstable intertrochanteric fractures in elderly patients is challenging due to osteoporosis. Comminuted unstable intertrochanteric fractures require early postoperative immobilization. Most of the recent reports have recommended Hemiarthroplasty for treatment of unstable intertrochanteric fractures to avoid various immobilization-associated complications like bed sore, pneumonia, urinary infection. The purpose of this study was to evaluate the functional and clinical outcomes of bipolar hemiarthroplasty for intertrochanteric fractures. Methods: Fifteen patients aged over 60 years underwent hemiarthroplasty to treat unstable intertrochanteric fractures and were followed up over 12 months. All surgeries were performed by the same surgical team using the Hardinge (lateral) approach. Wires, cables, and plates were used as required. Use of cemented protheses was considered when the lesser trochanter had been displaced. All patients were allowed full weight-bearing as tolerated as soon as possible. Clinical evaluation was based on Harris Hip Scores. Results: In our study, there were 6 male and 9 female patients with mean age of 70.26 years. 86.67% of the cases admitted were due to trivial trauma, 13.33% due to RTA with right side being more common side affected. In all patient partial weight bearing was started within 5 days. Good to excellent results were seen in 92.85% cases & Fair results were seen in 7.15% of cases in our study according to Harris Hip Score.Conclusions: Primary bipolar hemiarthroplasty for treating unstable intertrochanteric fractures provide a stable, pain free and mobile joint. It also eliminates the need for prolonged immobilization and permits early ambulation. As reported by others, hip hemiarthroplasty is an effective treatment choice for unstable intertrochanteric femoral fracture in older patients.