Background & objective: Intertrochanteric fractures are becoming increasingly common as our population ages. These fractures typically occur in frail patients with multiple comorbidities The morbidity associated with the fracture can be minimized by choosing appropriate fixation device for the fracture pattern, recognizing the stability of fixation, and performing accurate reduction with ideal implant placement. So, these fractures should be treated expeditiously so that there are minimum fixation failures. In BIRDEM hospital a large number of elderly patients having intertrochanteric femur fractures with multiple comorbidities, are treated by primary hemiarthroplasty. The purpose of this study is to see the clinical outcome of these hemiarthroplasty patients. Methods: This retrospective study was carried out over four years from 2015 to 2019 on 60 patients (42 females and 18 males). All patients had diabetes in common along with other co-morbidities like ischaemic heart disease, hypertension, chronic kidney disease and stroke. The outcome was evaluated by applying Harris Hip Score after intervention. Result: The mean age of the patients was 65.5 years (range: 60-85 years) with male to female ration being 3:7. The mean Harris Hip score at the four-year follow-up was 83.1 ± 10.9. A total of 12(20%) patients were graded as excellent, 30(50%) patients as good, 15(25%) as fair and 3(5%) as poor. It was observed that, patients with AO (Arbeitsgemeinschaft für Osteosynthesefragen) type 31A1 intertrochanteric fractures had better outcome than AO type 31A2 and 31A3 in our study. Conclusion: Primary hemiarthroplasty can provide a stable, pain-free, mobile joint with acceptable complication rates. These fractures must be treated considering patient’s age, bone quality and type of the fracture. Ibrahim Card Med J 2021; 11 (1): 35-40

Background & Objective: Intertrochanteric femur fractures are becoming increasingly common as our population ages. Effective treatment strategies that result in high rates of union of these fractures and low rates of complication are important. This study was designed to evaluate the clinical outcome of intertrochanteric fracture treated with dynamic hip screw, among many other fixation techniques available to fix intertrochanteric fractures. Methods: This prospective interventional study was done in the Department of Orthopaedics & Traumatology Department of Dhaka Medical College Hospital, Dhaka between June 2013 to November 2014. A total of 30 patients having intertrochanteric femur fracture were treated with Dynamic Hip Screw (DHS) after doing all necessary investigations for anesthetic fitness. Regular follow up was done up to six months after each operation and was observed for fracture healing, stability, complications and functional outcome by the prescribed scoring system (Harris Hip Score). Result: Nearly one third (30.0%) of the patients belonged to 7th decade and male to female ratio was 1:1.3. According to Harris Hip Score, 13(44.82%) patients were rated as excellent, 9 (31.03%) good, 5(17.24%) fair and 2(6.89%) poor. Conclusion: Dynamic hip screw (DHS) is a reliable method of fixing the stable intertrochanteric femur fractures. The reliability and long-term effect of dynamic hip screw used to treat intertrochanteric fractures of unstable variety are unsatisfactory and not up to the mark. Ibrahim Card Med J 2019; 9 (1&2): 36-41

Introduction: Appropriate treatment method for osteoporotic trochanteric fracture in elderly people is rather controversial because of the poor quality of bone mass, difficult anatomical reduction and accompanying systemic disorders. Internal fixation in these cases usually involves prolonged bed rest, limited ambulation and implant failure secondary to osteoporosis. This might result in higher chances of complications like pulmonary embolism, deep vein thrombosis, pneumonia, and decubitus ulcer. The purpose of this study is to analyse the role of primary cemented hemiarthroplasty in cases of osteoporotic intertrochanteric femur fractures in elderly patients with co-morbities. Materials and Methods: In this study, 120 cases of primary cemented hemiarthroplasty performed for osteoporotic intertrochanteric fractures were analysed retrospectively. There were 85 female and 35 male. Mean age of the patients were 65.2 years (range, 60-85 years). Harris hip score (HHS) was used to assess the outcome. Result: The mean Harris hip score at the two-year follow-up was 83.10 ± 10.90. A total of 25 patients were graded as excellent, 60 patients as good, 30 as fair and 5 as poor. It was observed that, patients with stable variety of intertrochanteric fractures had better outcome than the unstable variety in our study. Conclusion:Hemiarthroplasty for osteoporotic intertrochanteric fractures in the elderly patient results in early ambulation and good functional results, although further prospective randomised trials are required before reaching to conclusion.