Comparative study between trochanteric fixation nailing and cemented bipolar hemiarthroplasty for the treatment of unstable osteoporotic intertrochanteric neck femur fractures in elderly patients

Sonar, Ulhas; Ingle, Milind V; Koichade, Maruti R; Yelne, Avinash B; Malu, Naveen

doi:10.9790/0853-13633140

Cited by 2 publications

(2 citation statements)

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“…Hence there are two conflicting requirements that need to be addressed to in a balanced way. So despite the publication of reports of randomized trials and comparative studies treatment of unstable intertrochanteric fractures in elderly patients is still controversial [4] . In these patients due to combination of osteoporosis and instability, early resumption to full weight bearing is difficult.…”

Section: Introductionmentioning

confidence: 99%

“…Because of prolonged immobilization, complications like deep vein thrombosis, hypostatic pneumonia, pressure sores, dehydration, atelectasis, metabolic disturbances, etc are likely. So they have increased the morbidity and mortality threshold [4] . Despite advances in internal fixation techniques, the failure rate of the dynamic hip screw is 6.8% to 9.8% while failure rate of the proximal femoral nail is between 7.1% and 12.5% in unstable fractures.…”

Section: Introductionmentioning

confidence: 99%

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Functional outcome of unstable intertrochanteric femur fracture in elderly osteoporotic patients treated by primary cemented bipolar hemiarthroplasty versus internal fixation with proximal femoral nailing

S¹,

Patil²,

P³

et al. 2017

Int. J. Orthop. Sci.

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Backround: Intertrochanteric fractures in the elderly pose certain special problems and need to be addressed in a balanced way as on one hand senile osteoporosis requires prolonged immobilization, on the other hand rapid mobilization is required as they are generally medically compromised due to age and associated diseases. Despite several randomized trials and comparative studies treatment of unstable intertrochanteric fractures in elderly patients is still controversial, which we want to investigate in this set-up which caters to a vast rural population. Methods: A retrospective analysis of 54 patients, of which 27 each were operated with cemented bipolar hemiarthroplasty (BPA) and proximal femur nail (PFN) between January 2012 till July 2016 was done. Primary outcome was assessed in both groups using Harris hip score( HHS) at 4weeks, 6 weeks, 12weeks, 6months and 1 year on outpatient basis. The secondary outcome measures were intraoperative blood loss, transfusion rate, surgical time, bed to chair time, chair to walking time, limb length discrepancy at final follow up. All complications were noted at follow ups. Results: The HHS was significantly higher for BPA group at all follow ups, at 4 weeks of follow up was 77.81 for BPA and 71.18 for PFN (p-value = 0.001) and at 1 year of follow up was 85.55 for BPA and 77.03 for PFN (p-value = 0.001). Statistically significant differences were found between BPA and PFN groups with reference to intraoperative blood loss, transfusion rate, surgical time, bed to chair time, chair to walking time, limb length discrepancy at final follow up. Conclusion: The bipolar hemiarthroplasty group had fewer complications and earlier mobilization with better Harris hip score at all follow ups, which indicate bipolar hemiarthroplasty is a better option in the treatment of unstable intertrochanteric fractures in senile osteoporotic patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%