Primary bipolar hemiprosthesis for unstable intertrochanteric fractures

Abstract

Between 1997 and 2001 we treated 54 elderly patients with unstable intertrochanteric fractures by primary hemiarthroplasty using a cemented bipolar prosthesis. Mean patient age was 75.6 (64-91) years and mean follow-up was 22.3 (5-48) months. Seven patients died before the fourth post-operative month. Thirty-three patients were able to walk with a walker in the first postoperative week. There were no dislocations or aseptic loosening. One deep infection was encountered after 1 year. Acetabular erosion was seen in one patient and non-union of the greater trochanter was seen in four. Five patients experienced leg-length discrepancy. We obtained 17 excellent and 14 good results after 12 months according to the Harris hip-scoring system. We observed that the inner motion of the bipolar head decreased over time.Résumé Entre 1997 et 2001 nous avons traité 54 malades âgés avec fracture intertrochanterienne instable par hémiarthroplastie utilisant une prothèse bipolaire cimentée. L'âge moyen des malades était 75.6 (64-91) années et le suivi moyen étaient 22.3 (5-48) mois. Sept malades sont morts avant le 4e mois post-opératoire. 33 malades étaient capables de marcher avec un déambulateur pendant la première semaine post-opératoire. Il n'y avait pas de luxation ni de descellement aseptique. Une infection profonde s'est manifestée après une année.Une érosion acétabulaire a été notée chez un patient et une non -consolidation du grand trochanter chez quatre patients. Cinq malades avaient une inégalité de longueur des membres inférieurs. Nous avons obtenu 17 excellents et 14 bons résultats après 12 mois d'après le score de Harris. Nous avons observé que le mouvement intérieur de la tête bipolaire a diminué avec le temps.

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

“…Rodop et al [14] reported the results of 37 patients with unstable intertrochanteric femoral fractures, who underwent cemented, bipolar hemiarthroplasty, were followedup for 12 months, and 80% of whom obtained excellent and good results using the Harris hip-scoring system. Furthermore, in a study by Tang et al, [10] Harris hip scores were 83 and 80.2 in PFNA and hemiarthroplasty groups, respectively, with no statistically significant difference between the groups.…”

Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

“…[2] Classifications of these fractures are unreliable and therefore not useful in determining treatments. In general, fractures with comminution of the posteromedial cortex and subtrochanteric extension hemiarthroplasty were reported individually, [2,[10][11][12] to our knowledge, there has been no study comparing cemented and cementless hemiarthroplasty for intertrochanteric femur fractures in elderly patients. In the present study, we aimed to compare the reliability of cementless and cemented hemiarthroplasty for unstable intertrochanteric femur fractures in elderly patients.…”

Hemi Replacement Arthroplasty for Unstable Inter-Trochanteric Fractures of Femur

“…Poor bone quality, Excessive collapse, loss of fixation, and cut-out of the lag screw are the common problems of attempts to fix these fractures. Some surgeons have recommended prosthetic replacement in such fractures but this has not gained widespread support [4][5][6][7]. Present study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty in unstable inter-trochanteric fractures in elderly patients.…”