Interfragmentary approach total hip replacement in unstable intertrochanteric femur fracture in elderly shows better clinical result compare to standard posterior approach

Abstract

Introduction: Hip fracture is the most common fracture in elderly patients, with the rate of morbidity increasing is the main issues. The clinical as well functional outcomes are influenced by many factors, which includes patient condition, type of fracture, and definite treatment weather replacement or fixation. Patient and methodology: We carry out study in our center 54 patients presented to our center with unstable Intertrochanteric Femur Fracture with age more than 70 years old. Twenty Six of them (group 1) underwent standard posterior approach and 28 (group 2) underwent interfragmentary approach. Those patient with cognitive disorder and other neuromuscular disorder was excluded in this study. All of them was treated with Uncemented Total Hip Repalcement and Trochanteric Cable Plate with same type of implant. Statistical analysis: Latest version of SPSS software package was used for the statistical analysis of data. Categorical measurements were given as numbers and percentage values, whereas continuous measurements were given as mean and SD values (median and minimum–maximum when necessary). Their mean age was 82 (70-90) years, 14 males and 40 females with BMI is 20.2 (19.8-22.1.). Result: According to comparison of the groups, it was found that the rate of dislocation was statistically significantly higher in patient underwent posterolateral approach compare to interfragmentary approach. Trochanteric non union also is higher in group 1 compare to group 2. Conclusion: The option of Total Hip Repalcement with Trochanteric Grip Plate in elderly patient with osteoporotic bone through interfragmentary approach, give immediate stability and allow weight bearing and show good functional outcome with no complication at short term period.