Functional outcome of cemented bipolar prosthesis in unstable trochanteric fractures in elderly

Abstract

Background Hip arthroplasty in unstable trochanteric fracture warrants quick recovery with little risk of mechanical failure, avoids the risk associated with internal fixation, and enables the patient to maintain a good level of function immediately after surgery. Aim The aim of this study is to evaluate the clinical and functional outcomes of cemented bipolar prosthesis in unstable intertrochanteric fractures in the elderly. Patients and methods Twenty-four patients with unstable type of intertrochanteric fracture according to Association Osteosynthesis Classification were treated with hemiarthroplasty (cemented bipolar prosthesis) and reconstruction of trochanter. The average age of the patients was 79 years. We evaluated postoperative complications, mortality rate, functional outcome using the Harris hip score, time to return to preinjury level of activity, and radiological signs of healing and loosening or migration of implant. The range of period of follow-up was 2–5 years (mean: 3.5 years). Results Mobilization and full weight-bearing was started immediately within 1 week of surgery. The dislocation rate in our study was zero. Deep infection and loosening of the implant was not observed in any of the cases. The mean Harris hip score improved progressively with time of follow-up. The mean score was 45.30 on the third day. The final average Harris hip score at the last follow-up was 81.90. Limb length discrepancy was observed in seven patients and average shortening was 1.3 cm (range: 0.5–1.8 cm). Conclusion Hip arthroplasty in mobile and psychologically stable elderly patients with unstable intertrochanteric fracture is a valuable treatment option.

Keywords

• cemented bipolar prosthesis
• elderly
• harris hip score
• internal fixation
• unstable intertrochanteric fracture