Primary modular bipolar prosthetic replacement for unstable intertrochanteric fractures in elderly

Abstract

Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the functional outcome following primary modular bipolar prosthetic replacement for unstable intertrochanteric fractures in elderly. Materials and Methods: A prospective Study of 46 patients were evaluated from tertiary hospital for a period of Dec 2014 to June 2017. 46patients (40 females and 6 males-all were 75 years old or above) who had bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Lateral approach was used in all patients. Harris Hip Score (HHS) used for functional evaluation, however radiological follow up was done using plain X-rays. Follow up period ranged from 6weeks to 30 months Results: The Harris Hip Score were. 6 cases (12.5%) had excellent, 11(25%) had good, 23(50%) had fair and 6(12.5%) had poor results. In this study 5 cases had complications; like shortening in 2 patients, anterior thigh pain in 1 patients, decubitus ulcer in 1 patient, External rotation deformity in 1patient. Conclusion: Primary modular bipolar prosthetic replacement is a viable option for treatment in a selected group of previously independently mobile elderly patients with unstable intertrochanteric fractures and osteoporosis. The patients rapid return to the pre fracture level of activity significantly reduced the incidence of complications related to immobilization early walking with full weight bearing is the major benefit and goal of the procedure.