Unstable Trochanteric Fractures in Elderly Osteoporotic Patients: Role of Primary Hemiarthroplasty

Abstract

Unstable intertrochanteric fractures in osteoporotic patients are difficult to treat. Fixation failure often leads to prolonged morbidity and poor functional outcomes. The objective of the present study was to investigate primary replacement as a suitable option that could minimize complications in selected patients. From January 2004 to March 2007, 28 elderly osteoporotic patients with unstable intertrochanteric fractures were included in this study. Their fractures were classified according to the AO/OTA classification (8 patients, 31A2.2; 17 patients, 31A2.3 and 3 patients, 31A3.3) and their osteoporosis was confirmed by bone densitometry. Hemiarthroplasty was performed in all patients and the outcomes analyzed using the Harris hip score system. Of the 28 patients, 19 were women and the mean age was 79 years (range, 52-95 years). At a mean follow up of 4.2 years (range, 3-6 years), there were 17 excellent, 7 good, 2 fair and 2 poor results according to the Harris hip score system. In elderly osteoporotic patients with unstable intertrochanteric fractures, hemiarthroplasty is a reliable alternative to internal fixation. The functional outcome has been encouraging and we suggest it as a method of treatment in this group of patients.