Comparison of femur intertrochanteric fracture fixation with hemiarthroplasty and proximal femoral nail systems

Abstract

BACKGROUND:The aim of this study was to compare the outcomes of intertrochanteric femur fractures treated with proximal femoral nail (PFN) and bipolar hemiarthroplasty (BPH) in elderly patients.

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

“…These findings show that mobilization is much shorter in BPA group at each level which reduces overall hospital stay and complications related to it.In our study 2 patients of BPA group had bed sores and one patient had DVT which were treated conservatively, unlike the PFN group where these complications were not seen. These findings are similar to Görmeliet al [3] and Sameer et al [10] where these complications were either less or not seen in PFN group. The BPA group consistently had statistically significant higher Harris Hip Scores compared to PFN group at all the follow ups up to one year.…”

“…These complications can also be attributed the duration of surgery and invasive nature of surgery. We had 5 superficial surgical site infection and 1 deep infection in BPA group which were treated appropriately as per the infection control guidelines which is comparable to the results of Görmeli et al [3] . The superficial and deep infections in the PFN group in our study were 2 and 0 respectively, these results are same as Sameer et al [10] .…”

“…However, it is difficult to achieve and maintain a stable fixation in elderly patients due to their poor bone quality [3] . Intertrochanteric fractures in the elderly pose certain special problems.…”

“…Hemiarthroplasty and THA, as two possible treatment options for unstable intertrochanteric fractures, may offer the potential for quick recovery with little risk of mechanical failure, avoid the risks often associated with internal fixation, andenable patients to maintain a good level of function immediately after surgery [8] . Treatment of unstable intertrochanteric fracture is still controversial, despite of the publication of reports of randomized trials and comparative studies and their role in unstable osteoporotic and severely comminuted intertrochanteric fractures is still to be defined [3] . The purpose of this retroprospective study is to analyze and compare the role of primary cementedbipolar hemiarthroplasty (BPA) and proximal femur nailing (PFN) in cases of unstable osteoporotic intertrochanteric femur fractures in elderly.…”

Evaluation of proximal femoral nail-antirotation and cemented, bipolar hemiarthroplasty with calcar replacement in treatment of intertrochanteric femoral fractures in terms of mortality and morbidity ratios

“…In stable hip fractures, sliding nail maintains priority. [4] Hemiarthroplasty is always a treatment choice in unstable intertrochanteric femoral fractures. [5] Although hemiarthroplasty is a preferable alternative, intramedullary fixation techniques, which need less surgical cut, have been developed to protect patient's bone structure.…”