Unstable Intertrochanteric Femur Fractures Research Articles

Outcome of dynamic hip screw with trochanteric stabilizing plate in treatment of unstable intertrochanteric femoral fractures in elderly patients.

Objective: To know about the outcome of dynamic hip screw with trochanteric stabilizing plate in treatment of unstable inter-trochanteric femoral fractures in elderly patients. Study Design: Descriptive study. Setting: Maqsood Medical Complex, Pak Medical Centre and Habib Medical Complex. Period: August 2016 to July 2018. Material & Methods: Total of 70 patients with unstable inter-trochanteric fracture and age above 60 years were included in the study. The fracture was fixed with dynamic hip screw and trochanteric stabilizing plate. Patients were evaluated every month after surgery for healing of fracture. Final functional outcome was measured at 6 months after surgery with Harris Hip Score. Results: Out of 70 patients 44 (63%) were females and 26 (37%) were males. Mean age was 74.34(SD + 08.31) years with range of 60 to 87 years. Mean Harris Hip Score at 6 months was 85% with standard deviation of± 4.Ten (14%) patients had excellent, 40 (58%) patients had good, 16 (23%) patients fair and 4 (5%) patients poor functional outcome. Conclusion: Excellent and good functional outcome can be achieved in unstable inter-trochanteric fractures fixed with dynamic hip screw and trochanteric stabilizing plate in majority of patients.

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

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.

EVALUATION FUNCTIONAL OUTCOME OF HELICAL FIXATION PFN A2 IN PROXIMAL FEMUR FRACTURE IN ELDERLY

Background: Intertrochantric fractures are the most frequently operated fractures and has the highest mortality and morbidity rates. Evaluation functional outcome of helical fixation pfn a2 in proximal femur fracture in elderly
 Methods: Hospital based prospective randomized comparative study conducted on 30 patients with Close stable &unstable intertrochanteric femur fracture.
 Results: As per HHS, we have found that 76.67% cases (23) under excellent category and 20.00% (6) good and 3.33% (1) fair of HHS.
 Conclusion: We can conclude that the PROXIMAL FEMORAL NAIL ANTIROTATION2 is after proper training and technique a safe and easy implant option for treatment of complex peritertrochanteric fractures.
 Keywords: HHS, Femur, fracture

Usefulness of Synthetic Osteoconductive Bone Graft Substitute with Zeta Potential Control for Intramedullary Fixation with Proximal Femur Nail Antirotation in Osteoporotic Unstable Femoral Intertrochanteric Fracture.

PurposeThis study was conducted in order to examine the usefulness of osteoconductive bone substitutes with zeta potential control (geneX® ds; Biocomposites, England) by comparing the complications and radiographic evaluation with or without geneX® ds augmentation for internal fixation with proximal femur nail antirotation (PFNA) for treatment of osteoporotic unstable intertrochanteric fractures.Materials and MethodsA retrospective study of 101 patients who underwent fixation with PFNA in osteoporotic unstable intertrochanteric fractures was conducted from December 2015 to August 2020. The radiographic evaluation and complication rates were compared between patients with geneX® ds (Group A: 41 cases) and those without geneX® ds (Group B: 60 cases).ResultsIn radiological valuation, the degree of blade sliding from the time immediately after surgery to one year after surgery was 1.4±1.2 mm and 5.8±2.7 mm in Group A and Group B, respectively (P<0.001). During the same time frame, a significant difference of 2.3±2.2° and 7.4±3.1° , respectively (P<0.001), in varus collapse, was observed for Group A and Group B.ConclusionAmong patients fixed with PFNA for treatment of unstable intertrochanteric fractures, less blade sliding and varus collapse was observed for those with geneX® ds augmentation compared to those without it. In addition, there was no increase in the incidence of complications. The authors believe it can be regarded as a safe and effective additive for intramedullary fixation for treatment of unstable intertrochanteric fractures.

Intertrochanteric fractures treated by diaphyseal support arthroplasty with hook plate vs cerclage wires only: A retrospective cohort study

BackgroundThe treatment of unstable fractures of the intertrochanteric region of the hip in the elderly is controversial. Conventionally, internal fixation with intramedullary nail or a dynamic hip screw is the treatment of choice in intertrochanteric fractures. Nowadays, some authors encouraged the use hip arthroplasty for management of these fractures with good outcome. The aim of this study is to compare total hip arthroplasty with hook plate against total hip arthroplasty with cerclage cables in the management of unstable intertrochanteric fractures. Materials and methodsOut of 100 admitted patients to a central university hospital in Beirut between 2013 and 2019 with a diagnosis of unstable intertrochanteric fracture of the hip, only 64 (36 hook plate vs 28 cerclage) patients were selected. This is a retrospective study, patients were excluded if lost to follow up, or if follow up less than one year is available. The data were retrieved from inpatient and outpatient hospital files. Functional outcomes were assessed according to ambulatory capacity. The main clinical measures were early postoperative full weight bearing, postoperative complications, functional outcome and radiologic assessment done by a radiologist in addition to measuring the dysfunction via the Harris Hip Score. ResultsThe time to full weight bearing, the rate of postoperative complications, radiologic outcome and the functional outcomes were more satisfactory in the hook - plate group than in the cerclage - cable group. ConclusionAccording to the results, total hip arthroplasty with hook plate is considered the preferred modality of treatment in mobile elderly patients above sixty-five years of age with an unstable intertrochanteric femoral fracture, despite being a bulky foreign material that can lead to trochanteric bursitis.

Arthroplasty vs proximal femoral nails for unstable intertrochanteric femoral fractures in elderly patients: a systematic review and meta-analysis

BACKGROUNDProximal femoral nails (PFNs) are the most common method for the treatment of unstable intertrochanteric femoral fractures (IFFs), but postoperative bed rest is required. There is a large amount of blood loss during the operation. Osteoporosis in elderly patients may cause nonunion of fractures and other complications. Arthroplasty can give patients early weight bearing and reduce financial burden, but whether it can replace PFNs remains controversial.AIMTo compare the clinical outcomes of arthroplasty and PFNs in the treatment of unstable IFFs in elderly patients.METHODSA search was conducted in the PubMed, Embase, and Cochrane Library databases and included relevant articles comparing arthroplasty and PFN. The search time was limited from January 1, 2005 to November 1, 2020. Two investigators independently screened studies, extracted data and evaluated the quality according to the inclusion and exclusion criteria. According to the research results, the fixed effect model or random effect model were selected for analysis. The following outcomes were analyzed: Harris Hip score, mortality, complications, operation time, blood loos, hospital stay, weight-bearing time, fracture classification and type of anesthesia.RESULTSWe analyzed four randomized controlled trials that met the requirements. A total of 298 patients were included in these studies. According to the AO/OTA classification, there are 20 A1 types, 136 A2 types, 42 A3 types and 100 unrecorded types. Primary outcome: The Harris Hip Score at the final follow-up of the PFN group was higher [mean difference (MD): 9.01, 95% confidence interval (CI): 16.57 to 1.45), P = 0.02]. There was no significant difference between the two groups in the rate of overall mortality [risk ratio (RR): 1.44, P = 0.44] or the number of complications (RR: 0.77, P = 0.05). Secondary outcomes: blood loss of the arthroplasty group was higher (MD: 241.01, 95% CI: 43.06–438.96, P = 0.02); the operation time of the PFN group was shorter (MD: 23.12, 95%CI: 10.46–35.77, P = 0.0003); and the length of hospital stay of the arthroplasty group was shorter [MD: 0.97, 95% CI: 1.29 to 0.66), P < 0.00001]. There was no difference between the two groups in the type of anesthesia (RR: 0.99). There were only two studies recording the weight-bearing time, and the time of full weight bearing in the arthroplasty group was significantly earlier.CONCLUSIONCompared with PFN, arthroplasty can achieve weight bearing earlier and shorten hospital stay, but it cannot achieve a better clinical outcome. Arthroplasty cannot replace PFNs in the treatment of unstable IFFs in elderly individuals.

Is proximal femoral nailing of unstable intertrochanteric fractures in the lateral decubitus position without a traction table as safe and effective as on a traction table?

ObjectivesUsing proximal femoral nailing (PFN) in the lateral decubitus (lateral) position may be an option when no traction table is available. We hypothesized that applying PFN would be effective and reliable in the lateral position without a traction table. To test our hypothesis, we compared the two techniques in a prospective, randomized controlled study. Patients and methodsEighty patients (> 60 years of age) with unstable intertrochanteric fractures were randomly operated on prospectively in the lateral position without a traction table (Group 1) or in the supine position with a traction table (Group 2) between April 2018 and April 2019. We compared the surgery preparation time, total anesthesia time, duration of surgery, fluoroscopy exposure time, and amount of bleeding between the two procedures. The type-apex distance (TAD), collodiaphyseal angle (CDA), reduction quality, and lag quadrant were measured radiologically. The Harris Hip Score (HHS) was also calculated. ResultsThe mean follow-up time was 18.5 (14–27) months in Group 1 and 19.9 (14–27) months in Group 2. The mean follow-up time, mean age, sex distribution, and fracture pattern were similar between the groups. The preparation time and total anesthesia time of Group 2 were longer than those of Group 1, and the fluoroscopy time of Group 2 was shorter than that of Group 1 (p < 0.05). No significant differences in surgical time, bleeding amount, TAD, CDA, target lag quadrant, reduction quality, or the HHS were observed between the two groups. ConclusionsWe concluded that PFN is a safe and effective alternative for the treatment of unstable intertrochanteric femoral fractures when a traction table is not available in the operating room.

Therapeutic Effect of Artificial Joint Replacement for Unstable Intertrochanteric Fracture of Femur in Advanced Age

Therapeutic Effect of Artificial Joint Replacement for Unstable Intertrochanteric Fracture of Femur in Advanced Age

Comparative study of extramedullary versus intramedullary fixation for unstable Intertrochanteric femur fracture

Context: Most frequent fractures of proximal femur are intertrochanteric fractures which involve upper end of femur between both trochanters with or without extending into the upper femoral shaft occuring commonly in geriatric patients. Unstable contribute to about 50%-60% of all intertrochanteric fractures. Aims: Though intertrochanteric fractures unite without surgical intervention, malunion with coxa vara deformity occur with conservative management. The aim of fixation of intertrochanteric fractures is to prevent morbidity and mortality. With this aim of stable surgical reconstruct of intertrochanteric fracture this study was done to evaluate functional, clinical and radiological outcome of unstable intertrochanteric fracture operated with dynamic hip screw with trochanteric stabilization plate (extra meduary fixation) and proximal femoral nailing (intramedullary fixation) and study epidemiology and demographics of intertrochanteric femur fractures in Indian scenario. Settings and Design: Methods and Material: The study was conducted at New Civil Hospital Surat. 50 patients with unstable intertrochanteric femur fractures admitted between february 2018 to march 2019. Conclusions: In this study we found that both-extra-medullary or intramedullary fixation were able to provide good clinical result for unstable Intertrochanteric femur fracture. We conclude that there is statistically significant difference between patients operated with DHS with TSP (Extra medullary implant) and Proximal Femoral Nail (Intramedullary implant) in terms of Blood loss, Mean operative time and functional outcome. Harris hip score in patients treated with PFN had better Harris hip score at final follow up which was statistically significant. All patients in both groups had bony union at final follow up. Blood loss and duration of surgery was significantly less with intramedullary Implant.

A study to evaluate the functional and radiological outcome of proximal femoral nail Anti rotation 2 in inter trochanteric fractures of femur

Introduction: Fractures around the trochanteric area of the femur are among the most frequent fractures encountered in orthopaedics, especially in geriatric population and increasing life expectancy has resulted in increase in these type of fractures. Aim: The aim of this study was to analyze the functional and radiological outcome of patients treated with PFN A-II. Methods: Patients presenting with unstable intertrochanteric femur fracture (AO classification) and Singh’s index ≤ 3 were included. The study included 70 patients (30 males and 40 females), at our institution during the period of July 2019 to December 2020. Clinical outcome was measured in terms of procedure time, clinical function at each follow-up and mortality. Radiographic evaluation was measured by quality of reduction, Cleveland Index, tip-apex distance (TAD), and time for the union. Complications including delayed union, non-union, screw backing out , screw cut through into the joint, infection, osteonecrosis of the femoral head, and implant breakage were also investigated. Results: All the 70 patients included in the study were treated with PFN A-2. The average age of the patients included was 74.4 years . The TAD was more than 25mm in 8 patients. 11 patients has sub optimal position of the implant as per cleveland index. Outcome was excellent in 45, good in 15, fair in 7,poor in 3, and this is based on modified Harris hip score with the minimum follow-up period being 6 months. The difference between the neck shaft angle of the operated side when compared with the un-injured side is more than 10 * in 11 patients. The average union time was 5.6 weeks, average modified Harris hip score was 86.5. Conclusion: The result of our study shows that PFNA2 is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation in the osteoporotic patients , which allows early full weight bearing mobilization of the patient.

Study of functional outcome of intertrochanteric femur fractures fixed with proximal femoral anti-rotation (PFNA2) nail

Introduction: Intertrochanteric fractures are one of the commonly occurring injuries in elderly patients and are high among females and those with osteoporosis. Unstable intertrochanteric femur fractures are treated commonly with intramedullary nails. Newer designs like Proximal Femoral Nail Antirotation-2 have been introduced for Asian population. The aim of our study was to compare the radiological and functional outcome of unstable intertrochanteric femur fracture treated with Proximal Femoral Nail Antirotation-2 nails. Methodology: This study was carried out at Department of Orthopaedics, Tertiary care Hospital. During this period, 36 patients with intertrochanteric femur fractures were identified of which 34 patients were enrolled in the study based on the inclusion and exclusion criteria. With 4 patients being lost to follow-up during the course of study before completing at least 6 months of follow-up, we had 30 patients remaining to study. Results: Harris Hip score was applied to assess outcome. 22(74%) had good to excellent results. 8 (26%) had fair to poor results. However, radiologically none of the patients had poor results. We cannot readily rule out objective bias in our radiological assessment. Conclusion: Early surgery on patients with trochanteric fractures improved its ability to return to independent living and complications of prolonged immobilization are prevented. PFNA2 has advantages like less surgical time for fixation, less fluoroscopy time, optimum for small neck, less blood loss and it is better suited for Asian population.

Assessment of factors resulting to functional outcome of intertrochanteric fracture of femur managed by proximal femoral nail: Antirotation 2 (PFNA 2)

Background: Intertrochanteric femur fracture management in elderly needs more attention to reduce malunion and increase early mobilisation to reduce mortality and morbidity. Ideal choice of treatment is internal fixation by intramedullary or extramedullary devices. Intramedullary devices provide more stable proximal femoral anatomical fixation. Between PFN and PFNA; helical blade in PFAN provides more stability, better compression and rotational control with lower cut-out rate. Aim: a) To assess the factors for functional outcome of PFNA2. b) Evaluation of effectiveness and stability of PFNA 2. Material and Methods: 30 patients with unstable Intertrochanteric femur fracture between Nov 2020 to July 2021 fulfilling inclusion and exclusion criteria were included in this study and underwent closed reduction and intermal fixation by PFNA(n=30). Assessment was done in terms of demography, preoperative and intraoperative variables, postoperative parameters mainly functional outcome till 1 year postoperative. Results: Preoperative variables, AO fracture type were assessed preoperatively. Duration of surgery, blood loss and fluoroscopy imaging were significantly lower in PFNA as compared to PFN. Postoperative complications like cut-out rate, shortening, varus malalignment, return to pre-fracture state were also lower in PFNA group than PFN. Postoperative functional assessment done by Harris Hip Score shows better outcome in PFNA than other fixation devices. Conclusion: PFNA reduces duration of surgery, blood loss, fluoroscopy imaging as compared to other implants. PFNA also offers better postoperative functional outcome.

A prospective study of surgical management of intertrochanteric femur fracture in adults with short proximal femoral nail

The AO/ASIF proximal femoral nail (PFN) is a new device designed for the treatment of the unstable intertrochanteric femoral fracture. This study reports the outcome in such fractures treated using the short PFN (proximal femoral nail). All patients presenting to our department with unstable trochanteric femoral fractures were treated operatively using the short proximal femoral nail. A total of 40 patients were included in the study and were followed-up at regular interval of 1, 3, 6 and 12 month. The functional outcome of the patients was assessed by modified Harris hip score at regular intervals.Results: All 40 patients treated with short pfn. In this study first follow up was at 4 weeks, radiological union was noted in 9(22.5%) patients. At second follow up at 12 weeks, clinical union was noted in 85% of patients and radiological union noted in 90% patients. At 6 month follow up all 40 patients showed signs of clinical and radiological union. Post-op 1 patient has superficial wound infection and 3(7.5%) patients operated with short PFN showed varus deformity. Patient were functionally evaluated by modified Harris Hip Score at regular follow-ups. In our study 87.5% of cases showed good to excellent results and rest 12.5% of cases showed fair results.Conclusions: It is concluded from our study that short proximal femoral nail is an stable and suitable implant for Proximal Femoral Fractures and its use in unstable intertrochantric fractures is very encouraging.

Evaluation of results of unstable intertrochanteric femur fracture treated with dynamic hip screw and trochanteric stabilizing plate

Intertrochanteric fractures are more common in the elderly as compared to that in young. These fractures unite readily with conservative line of management as compared to that of neck femur fractures which have an inherent risk of increased complication like avascular necrosis. The study was conducted to evaluate the functional outcome of treating unstable intertrochanteric fractures in individuals using trochanteric stabilising plate [TSP] with dynamic hip screw [DHS]. With prior approval form the ethical committee the study was conducted on the patients admitted in SMIMER, Surat from September 2016 to October 2017 with diagnosed unstable intertrochanteric fracture. Total 58 patients with unstable intertrochanteric fractures were managed with DHS TSP, of which 48 follow up was possible. Loss of follow up was due to death of 8 patients whereas 2 were due to loss of patient follow up. The patients were informed about the study in all respects and informed written consent was obtained from each for the operative procedure and for enrolment in the study. In the study conclude from that for surgeons familiar with the DHS implant system, the modular TSP extension is a safe effective solution to stabilize selected unstable intertrochanteric fractures.

Comparison of the Curative Effects of Hip Arthroplasty with Bio-Type Femoral Stem and Cemented Femoral Stem in Elderly Patients with Unstable Osteoporotic Intertrochanteric Femur Fractures

Comparison of the Curative Effects of Hip Arthroplasty with Bio-Type Femoral Stem and Cemented Femoral Stem in Elderly Patients with Unstable Osteoporotic Intertrochanteric Femur Fractures

Proximal Femoral Plate, Intramedullary Nail Fixation Versus Hip Arthroplasty for Unstable Intertrochanteric Femoral Fracture in the Elderly: A Meta-analysis.

Multiple operative modalities are available for management of unstable intertrochanteric femoral fractures. This meta-analysis was conducted to find out if there is superiority of surgical fixation by proximal femoral plate or surgical fixation by intramedullary nail over hip arthroplasty for management of unstable intertrochanteric femoral fractures in the elderly. A search for relevant studies that published from January 2000 to November 2018 through the electronic literature database of Cochrane library, Medline, Trip Database and Wiley online library. A total of 19 studies including 14 prospective RCTs, and five retrospective studies. This meta-analysis showed that nail group had shorter operative time than plate group (P < 0.0001), and less blood loss than the plate and arthroplasty groups (P < 0.0001), cut-out was higher in nail group than the plate group (P < 0.0001), mortality rate was higher in hip arthroplasty compared to other groups (P < 0.0001), Harris hip score within 6months of the operation was higher in the arthroplasty group compared with the nail and plate groups, while within 1 year of the operation, nail group had higher Harris hip score than arthroplasty group (P < 0.0001). This meta-analysis suggested that the intramedullary nail fixation method is a preferred method for management of unstable intertrochanteric femoral fractures in the elderly over hip arthroplasty and proximal femoral plate fixation. The online version contains supplementary material available at 10.1007/s43465-021-00426-1.

Functional Outcome of Cemented Bipolar Hemiarthroplasty For Unstable Intertrochanteric Femur Fracture in Elderly Osteoporotic Patients

Functional Outcome of Cemented Bipolar Hemiarthroplasty For Unstable Intertrochanteric Femur Fracture in Elderly Osteoporotic Patients

Outcomes of Wedge Wing in the Lag Screw for Unstable Intertrochanteric Fractures in Elderly Patients.

PurposeTo evaluate clinical-functional and radiologic outcomes of elderly patients with an unstable intertrochanteric femur fracture treated with a wedge wing in the lag screw.Materials and MethodsForty-eight patients treated with the Dyna Locking Trochanteric nail (DLT nail) to resolve an unstable intertrochanteric femur fracture were reviewed retrospectively. Based on AO/OTA classification, Fracture 31-A2 (34 cases) and 31-A3 (14 cases) were included in the analysis. We measured the femoral neck-shaft angle, tip-apex distance (TAD), Cleveland index, sliding distance of the lag screw, and time to the fracture union. The Harris Hip Score and Paker and Palmer's mobility score for clinical evaluation were used.ResultsThe mean follow-up period was 21.4 months (range, 12–34 months). The postoperative state of reduction was good in 28 cases and acceptable in 20 cases. The mean TAD was 20.5 mm. The position of the lag screw was center-center in 30 cases and center-inferior in 18 cases. The mean sliding distance of the lag screw was 3.4 mm at the last follow-up. The mean union time was 4.5 months. Two cases had complications which included a cut-out (1 case) and non-union (1 case). The mean Harris Hip Score was 86.5±8.3 (range, 76–90). Walking ability in 34 of the cases (70.8%) at last follow-up was similar to that prior to fracture.ConclusionFunctional and radiological outcomes are satisfactory using the DLT nail in the treatment of elderly patients with unstable intertrochanteric fractures; however, wedge wing in the lag screw does not prevent implant-related complications.

386 Proximal Femoral Nail (PFN) Versus Dynamic Hip Screw (DHS) In Unstable Intertrochanteric Fractures of Femur -A Comparative Clinical Study

Abstract Introduction The goal of treatment of an intertrochanteric femoral fracture is restoration of patient's mobility as early as possible. The dynamic hip screw (DHS) has been used for several decades to treat these fractures. Proximal femoral nails (PFN) are reported to have an advantage in such fractures. This study aims at comparing the results of unstable intertrochanteric fractures femur treated with PFN and DHS. Method This was a prospective, randomized study which includes sixty patients. All patients were available for follow up with 30 patients in each group. The data about intraoperative blood loss, time to union, leg length shortening was collected. The functional outcome at the end of one year was evaluated using Harris Hip Score. Results Blood loss, duration of surgery, time to union and leg length shortening was significantly less in the patients treated with PFN (p &amp;lt; 0.05). The mean harris hip score for patients managed with PFN was significantly more than in DHS group, 12 months after surgery (p = 0.05). Conclusions PFN requires a smaller incision, lesser operative time, less blood loss and has improved functional results. In our opinion PFN may be a better fixation device for most of the unstable intertrochanteric femur fractures.

Evaluation of results of intertrochanteric femur fracture treated by hemi arthroplasty

Purpose of study: To assess functional outcome in patients having unstable intertrochanteric fracture treated by Hemiarthroplasty as per harris hip score. Method: 25 cases of unstable intertrochanteric femur fracture were operated and followed up at Gcs Medical college, Hospital & Research Centre, establishing the following as Inclusion criteria: Patients more than 50 years of age with unstable intertrochanteric femur fracture(AO 31A-2.2, AO 31A-2.3) presenting primarily or following failed osteosynthesis, who were ambulatory before fracture & Exclusion criteria: Patients who are medically unfit for anesthesia, stable fracture pattern, infection around hip, compound fracture, chronically debilitated and bed bound patient; with informed consent regarding procedure and study. Mean age of patients was 71.12 years. All patients are treated with hemiarthoplasty. Patients are followed up for a mean period of 6 months. Results: These patients were evaluated using the Harris hip scoring system. 22 out of 25 had excellent to good outcomes. Conclusion: Hemiarthoplasty offers good functional outcome and early weight bearing and mobilization.