Prospective study of functional outcome of unstable intertrochanteric fractures with hemiarthoplasty using bipolar prosthesis

Abstract

Introduction: From many years the treatment for intertrochanteric fracture is internal fixation. Now hemiarthoplasty is being considered as a primary modality of treatment in unstable intertrochanteric fractures as it allows immediate full weight bearing and stability. Aim of present study is to analyse and evaluate the role of hemiarthoplasty in unstable intertrochanteric fracture. Materials and Methods: 20 patients with unstable, comminuted intertrochanteric fractures aged above 65yrs are considered in the study from January 2016 to December 2019. Exclusion Criteria: 1. Age less than 60yrs; 2. Stable intertrochanteric fractures; 3. Pathological fractures. Southern moores posterolateral approach was used. Cemented bipolar prosthesis was used in all cases. All cases were followed up for 1year. Patients were assessed using modified Harris hip score. Results: Average age in our study was 70 years according to boyd and griffin type 2 fractures were 16, type 3 were 4 patients. 2cms shortening seen in 5 patients, whereas1patient had limb shortening of 3 cms. Gluteus medius weakness was seen in 3patients. All cases were assessed using modified harris hip score, in 15 cases excellent to fair results were seen (75%), where as 2 cases (10%) had poor results. 3 patients died during the course of follow up and are excluded from study. In our study we had no Complications like stem loosening, periprosthetic fractures, infection and prosthetic dislocations. Conclusion: Primary cemented hemiarthroplasty can be used as an alternate to internal fixation for unstable trochanteric fractures. Keywords: Unstable fractures, Primary hemiarthroplasty, Harris hip score.