Intertrochanteric fracture of femur in elderly – A comparative analysis between hemiarthroplasty and osteosynthesis

Abstract

Background: Fixation of Intertrochanteric fractures Boyd and Griffin type 3 & 4 in elderly is a challenge due to its fracture pattern & the need to protect the fixation from stresses of weight bearing, to prevent implant failure secondary to osteoporosis is common. As elderly patients have existing high risk of morbidity delay in ambulation and prolonged bed rest adds to the morbidity. Objective: The study was to compare the effectiveness of Bipolar Hemiarthroplasty and Osteosynthesis for Inter-trochanteric fracture of femur in elderly and to evaluate and compare functional & anatomical outcome based on clinical & radiological follow up. Method: A total of 50 patients diagnosed with Intertrochanteric fractures Boyd and Griffin type 3 and 4 admitted in our hospital and satisfying the eligibility criteria were taken in the study. A Hospital Based comparative study was conducted at Department of Orthopedics, D Y Patil University School of Medicine & Hospital, Navi Mumbai for a duration of 2 years from September 2014 to September 2016. Result: An excellent result with regards to final range of motion and pain as assessed by the Harris Hip Score was achieved in Bipolar Hemiarthroplasty group. Conclusion: The greatest advantage of hemiarthroplasy is being able to walk with full weight bearing post-surgery and also the complications of non-ambulation are negated, which also reflects on the functional outcome. Hemiarthroplasty in these cases is a surgically demanding technique and should be performed by experienced operators.