Comparison of the Clinical Outcomes between Internal Fixation and Primary Hemiarthroplasty for Treating Unstable Intertrochanteric Fracture in the Elderly

Moon, Chang Yun; Ji, Jong‐Hun; Park, Sang Eun; Kim, Young‐Yul; Lee, Se Weon; Kim, Weon Yoo

doi:10.5371/jkhs.2008.20.4.273

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…In addition, postoperative early ambulation may not be feasible, and the rates of postoperative complications and mortality are high due to combined disorders. Accordingly, postoperative early ambulation and rehabilitation should be taken into account when considering treatment options, and hemiarthroplasty is regarded as one of the most effective primary treatment methods for unstable intertrochanteric fractures 3,4,17,18)…”

Section: Discussionmentioning

confidence: 99%

“…The achievement of initial press-fit fixation is essential for early ambulation and rehabilitation. In one study, hemiarthroplasty produced better postoperative results than internal fixation in terms of limping and the use of a walking aid in patients with limited walking ability before surgery 18). Considering that press-fit fixation in the proximal femur is difficult to achieve in elderly patients with unstable fractures, the use of a cylindrical implant that can be fixed to the isthmus or diaphysis can be helpful.…”

Section: Discussionmentioning

confidence: 99%

“…In one study, hemiarthroplasty produced better postoperative results than internal fixation in terms of limping and the use of a walking aid in patients with limited walking ability before surgery. 18) Considering that press-fit fixation in the proximal femur is difficult to achieve in elderly patients with unstable fractures, the use of a cylindrical implant that can be fixed to the isthmus or diaphysis can be helpful. The AML implant is effective in improving the initial rotational stability owing to its broad triangular shape in the proximal portion.…”

Section: Discussionmentioning

confidence: 99%

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Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients

Choy

Ahn

et al. 2010

Clin Orthop Surg

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BackgroundBipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients is a viable option that can prevent the complications of an open reduction, such as nonunion and metal failure. This study evaluated the clinicoradiological results of cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients.MethodsForty hips were followed for more than 2 years after cementless bipolar hemiarthroplasty using a Porocoat® AML Hip System. The mean age was 78.8 years and the mean follow-up period was 40.5 months. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using a range of indices.ResultsAt the last follow-up, the mean Harris hip score was 80.6 points. There were one case of hip pain and one case of thigh pain. Twenty-four cases (60%) showed no decrease in ambulation capacity postoperatively. Radiologically, there were 23 cases (57.5%) of fixation by bone ingrowth and 17 cases (42.5%) of stable fibrous fixation. There were no cases of osteolysis. Eleven cases (27.5%) of new bone formation were found around the stem. All stems were stable without significant changes in alignment or progressive subsidence.ConclusionsThe short-term results of cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients

Choy

Ahn

et al. 2010

Clin Orthop Surg

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“…Cemented fixation is advantageous for enhancing the initial fixation strength in aged patients with poor bone quality [11], whereas cementless fixation facilitates biological fixation and can avoid cardiovascular toxicity [12]. Some studies have reported positive outcomes in arthroplasty using cementless implants in elderly patients with an improvement of the implant design, material and insertion technique [8,13].…”

Section: Groupsmentioning

confidence: 98%

What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists (ASA) class III patients with femoral neck fractures? Cemented or cementless

Çıçek¹,

Seyfettinoğlu²,

Kılıçarslan³

et al. 2015

Injury

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Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients

et al. 2012

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Purpose:This study was performed to compare the clinical results and complications of bipolar hemiarthroplasty and internal fixation using proximal femur nail antirotation (PFNA) for unstable elderly femoral intertrochanteric fractures. Materials and Methods:From May 2008 to September 2010, 74 patients older than 65 years who underwent bipolar hemiarthroplasty(33 patients) or PFNA(41 patients) and followed for more than 1 year after surgery were enrolled in this study. The mean blood loss during operation, mean operation time, radiological results, clinical results, and complications were analyzed by the Student t-test and Chi-square test to compare the two groups. Results:The volume of blood loss during the operation was statistically lesser in the PFNA group (P<0.05) and operation time was not statistically different between the two groups (p=0.73). The bipolar hemiarthroplasty group showed a statistically better outcome than the PFNA group in the beginning of weight bearing (p<0.05), the hospital stay (p<0.05). The degradations of Koval score and modified Harris hip score of the bipolar hemiarthroplasty group were statistically better than those of the PFNA group (p=0.03, p=0.02). The bipolar hemiarthroplasty group showed a statistically lower incidence of mechanical(9.1%, p=0.01) and general(12.1%, p=0.00) complications than the PFNA group. Conclusion:In elderly patients, bipolar hemiarthroplasty is thought to be one of the effective treatments for unstable femoral intertrochanteric fracutures when considering complications and clinical outcomes.

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Comparison of the Clinical Outcomes between Internal Fixation and Primary Hemiarthroplasty for Treating Unstable Intertrochanteric Fracture in the Elderly

Cited by 3 publications

References 15 publications

Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients

Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients

What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists (ASA) class III patients with femoral neck fractures? Cemented or cementless

Comparison between the Results of Internal Fixation Using Proximal Femur Nail Anti-rotation and Bipolar Hemiarthroplasty in Treatment of Unstable Intertrochanteric Fractures of Elderly Patients

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